Pain is often optional.
You just have to know how to treat it.
You just have to know how to treat it. Eileen Kopsaftis, a manual therapist who focuses strongly on pain, has made multiple appearances on The Mindful Injury Recovery Talks – there are two other discussions for you to check (find the links below).
In this interview, we went into detail about things that we can address with proper physical therapy and lifestyle adjustments so we can avoid pain medication, or potentially life-altering procedures or addictions.
Tune in to discover:
- How the right physical therapy can save you weeks, months, or years of suffering.
- Which meds can cause more pain and which painkillers might not be as effective as we hope they are.
- How to reduce inflammation and pain naturally.
- What to do when you’ve already ‘tried everything’ without much success.
Tune in + Share ❤
Show notes & links
The show notes are written in chronological order.
- Eileen Kopsaftis’ website: https://havelifelongwellbeing.com
- Eileen Kopsaftis’ book:
- Pain Culprits! [get the book here]
- Episode 2: Eileen Kopsaftis – Retraining the Body and the Mind to Eliminate Pain
- Episode 31: Eileen Kopsaftis – How to Cope With Pain and Prevent Osteoarthritis
- The Wellness Forum Institute for Health Studies is the first school in the U.S. to offer certificates and diplomas based on the philosophy of evidence-based healthcare using diet and lifestyle as primary intervention tools.
- Chronic non-cancer pain and opioid use: Population-based studies, PhD Thesis by Hanne Birke [read it here]
- New York Times article on Dr. Peter Gotzsche’s work [read it here]
- Minagawa, H., Yamamoto, N., Abe, H., Fukuda, M., Seki, N., Kikuchi, K., Kijima, H., & Itoi, E. (2013). Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village. Journal of orthopaedics, 10(1), 8–12. [read it here]
- Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., Halabi, S., Turner, J. A., Avins, A. L., James, K., Wald, J. T., Kallmes, D. F., & Jarvik, J. G. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR. American journal of neuroradiology, 36(4), 811–816. [read it here]
- Lilly, D. T., Davison, M. A., Eldridge, C. M., Singh, R., Montgomery, E. Y., Bagley, C., & Adogwa, O. (2021). An Assessment of Nonoperative Management Strategies in a Herniated Lumbar Disc Population: Successes Versus Failures. Global spine journal, 11(7), 1054–1063. [read it here]
- Osteoarthritis results from inflammatory process, not just wear and tear, study suggests [read it here]
- James Allen: As a Man Thinketh [get the book here]
- The Complete Wallace D. Wattles [get the book here]
- John Sarno, MD was a pioneer in mind-body medicine. His books are helping many patients to become free of pain after “mainstream medicine” fail to help. [also, discover more here]
- Dr. Jonathan Kuttner is a musculoskeletal pain specialist who has spent the last 35 years working as a doctor in New Zealand. He is the recipient of the NAMTPT Lifetime Award for Contribution to Myofascial Trigger Point Therapy and has been featured on national TV and radio in Australia and New Zealand. He’s the author of the book Life After Pain.
- Dr. Jonathan Kuttner: Life After Pain [get the book here]
- MELT Method is a gentle self-care technique that enhances mobility, stability, and performance and is clinically proven to reduce chronic pain while restoring overall wellbeing.
00:00 – excerpt from the episode
00:52 – intro (listen to discover a little more about your host. Martin will tell you a new lesser-known fact about Dr. Maya)
Dr. Maya Novak:
When I did my first interview with Eileen Kopsaftis in 2019, I knew I wanted to dig even deeper with her. This is the reason why there are three episodes with her available to you on my podcast – check out also episode 2 and 31.
In this interview, we spoke extensively about how different kinds of medication can cause more pain and which painkillers might not be as effective as we hope they are; also how to deal with pain and what to do when you’ve already ‘tried everything’ without much success, and much more. Please enjoy this helpful conversation.
Dr. Maya Novak:
In this interview, I am joined by Eileen Kopsaftis who is a pain and chronic conditions specialist. She has been practicing physical therapy for 25 years and 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 lifelong wellbeing because, truthfully, life is meant to be enjoyed, not endured. Her book Be Painless is going to be published later this year. Eileen, thank you for joining me.
Thank you for having me. I’m humbled and honored to have been asked.
Dr. Maya Novak:
Thank you. When we were talking about what we can potentially discuss in this interview a few weeks ago, I was already really, really excited. But before we go into the juicy part, can you share a bit about who you are, why you decided to become a PT, and when did you also start being interested in nutrition and other self-care techniques?
Yes, well the same answer will sort of touch both topics. So when I was really little I wanted to be a doctor and when I graduated high school and started looking at advanced learning, I realized that I really did not agree with the medical model that’s practiced in this country. I have nothing against physicians, my goodness. They’re great people. Anybody who gives up 12 years of their life to help others is a good person. But I didn’t agree with medicating symptoms and treating symptoms and addressing blood biomarkers without looking after overall health, which is not really the emphasis in our medical model – at least in this country. So I decided to wait on going to College for a while. Well, fast forward, I ended up getting married and having children. I was 30 when I went back to College, so I’m a late bloomer, right? Anyhow, when I started looking, I really wanted to be a nutritionist. I wanted to focus on nutrition. I had already independently studied from nutrition almanacs at home and was an avid reader on the subject. I realized the relationship between food and disease and chronic and things that can be prevented and/or at best a very positive intervention. So that was my focus and I started looking at local Colleges and what was offered. Being a mom I didn’t want to travel, I didn’t want to go anywhere. So there were several Colleges that offered good nutrition courses, I looked through their catalogs, and I realized they were teaching things that I did not agree with. They were still teaching the four food groups, right, and all that fun stuff that is really passé at this point, but I realized well if I’m arguing with the professors, I probably won’t pass the course! So I decided well, maybe that’s not for me. So I’m thumbing through this one College manual and I came across the Physical Therapy program. I was fascinated with the human body my whole life, the muscular and skeletal and all of that – how we function and all. So I thought wow, maybe this is it. Every time I called the College to ask about the program, to ask questions, it was almost like they were trying to talk me out of it. It was oh, it’s a very challenging program. When I hear the word challenge, my horns come out and I’m like okay, I’m going to do this. So that’s how I ended up becoming a PT. Now the interesting part is, is again, fast forward many years later The Wellness Forum Institute for Health Studies began the only program in the country that teaches nutrition that is not industry biased or supported or funded and therefore it’s very independent and it’s very research data proven oriented. It teaches its students how to be able to eliminate the need for medication and actually reverse chronic conditions. It’s an extensive program. It’s 900 hours. So I entered that program. I did it part-time; it took me about seven years because I working and I had my own consulting business at the time. But it’s enabled me to help people in profound ways because now when a patient walks through the door, not only am I very aware of the musculoskeletal issues and the neurological issues, but I’m also very aware of any nutritional issues, chronic disease issues, and things like that. So I think that it’s really made me much more capable of helping people than I was before.
Dr. Maya Novak:
Definitely, because it’s not only that you’re just your shoulder, or you’re just your hip, or you are just your ankle and that’s it. It doesn’t work that way, right?
And even when you look at organs, my mom when she was very ill and she was in ICU, you had all of these different doctors coming in for different body parts. So you had the kidney doctor, and the lung doctor, and the blood doctor, and they’re all – none of them were talking to each other. It just boggled my mind. I felt like I couldn’t leave her bedside and I had to focus on every person who walked through the door to make sure that they were aware of all of the other things because we are – you know – everything is connected to everything else. I had a doctor one time who was – I won’t get off on a tangent – but I had to call a doctor one time about one of my homecare patients because she had numbing in her legs. She had serious heart conditions and congestive heart failure, you know, slower legs – it kind of goes together – but that wasn’t his area and I needed to call a different doctor. I’m thinking are you kidding me. So the medical world has become quite compartmentalized, but the human body is not compartmentalized.
Dr. Maya Novak:
Yeah, very, very true. But if we go back to physical therapy – so why is PT even important? What does it do and why do we need it after an injury, after an accident?
That’s a very good question. I think that it’s really important for people to seek out someone who is aware of how everything is connected and ensure that they are addressing issues that could come back to bite them later if they don’t address them now. For instance, if I see – I’ll give an example – I get a lot of young athletes in the clinic. We are right across the street from one of the local schools. More and more athletes, by the way, are getting injured – young kids – because they’re doing sports year round. They’re doing multiple sports year round. I tell them – the people making millions of dollars a year having a good season, but for a reason, your body needs to rest! But anyhow, young people are getting injured and quite often they’ll come in and they’ll have a knee problem, or a shoulder problem, and when I question them they had an issue a year or so ago, maybe two years ago, and it was never addressed with PT. So now because of that, that body part did not recover properly, it’s lacking motion, it’s lacking stability and therefore it puts them at risk for further injury in the body. They’re not even aware that that dysfunction is happening.
Dr. Maya Novak:
Yeah, very true, but you know, there are so many different PT’s. My experience is some are more focused on exercises, others are more focused on using machines, then others are completely focused on something else, but you are also doing manual physiotherapy. So what’s the difference between conventional and manual?
Well, those are kind of my terms in a way. I consider conventional physical therapy when someone goes into a clinic that unfortunately sees way too many people per hour. I call them cattle clinics. They herd them in and they herd them out. It’s very, very sad and it’s a big black eye on my profession in my professional and personal opinions. Most PTs who work in those environments are burned out. They’re very unhappy. They have no job satisfaction. They’re really not helping people. When you’re standing in line at the supermarket and you hear someone say, oh, I had PT, it didn’t work. I can pretty much guarantee you they went to one of those types of places, right. So what happens is they’re seeing three or people per hour. The first people who go into that clinic are not – they’re getting seen for maybe 10 minutes, tops. They’re seeing a technician or an assistant most of the time if they’re seeing anyone. Sometimes they’re doing their exercises independently. Some clinics patients get their own ice packs out of the freezer. They put their own ice packs on when they’re done with exercise. So the interesting thing that I’ll get to in a minute is the high cancellation rate of those people. So conventional PT is a cattle call where people are going in and they’re getting lots of modalities and unfortunately the modalities are being used and this is – I don’t want to say it’s a dirty little secret – but it’s kind of a common tactic used in very busy clinics, they prime the patient this way. They start them with heat and then move to exercise, and then we’ll finish them with ice. So now, the patient has been there for an hour or more. They might have gotten their co-pays worth of time, right, but they have really not gotten any true therapy. And then ultrasound – some clinics will use technicians to do the ultrasound, or assistants to the ultrasound, or electrical stimulation and stuff like that. I’m not saying those modalities don’t have a place, but I think they’re way over utilized in a way that short changes the patients. I very rarely use modalities in my practice that work in, and really, the modalities that sit there kind of collect dust most of the time. We really don’t use them all that often. I use ultrasound, but very rarely and for very specific purposes. When I graduated College, there was no literature that showed what actually did as far as healing by currents. They knew that it heated up the tissues two to three centimeters below the surface, depending on whether you’re using continuous or pulse or however you’re setting the head to be working. But the funny part is there was really no data that showed that it was doing, everybody was just kind of guessing, and it was all theoretical. Well, if we’re heating up the tissue and we’re improving blood flow, we must be increasing the healing rate, but nobody knew. There was no data. It’s been in the last few years that data’s come out about ultrasound effectiveness. So for decades, things have been used and no one knows what it was really doing. So with conventional PT, there’s lots of modalities – heat, ice, these damn ultrasounds, and conventional exercise. If you’re a knee patient, you’re going to get a string of knee exercises, right. My favorite is this one – so pretend this is my knee and they have them sit and they have them do this, right - open chain knee extension. I had a homecare patient once who I went in to work with and he was rolling his eyes when I came in, oh, here comes the PT. He starts to straighten his leg and I said what are you doing? He said isn’t that what you’re going to have me do? I said, if I’m going to have you do that, that’s not going to get you walking and he just was shocked, oh my gosh. Somebody who’s not going to have me do something useless! So he and I ended up having a great rapport, I helped him, and he learned how to walk. So that’s the conventional PT.
Then the manual PT is very different. Manual PT is going to look at the person completely. We’re going to look at you from head to toe. It doesn’t take forever. A good evaluation and treatment, initial treatment should be one hour, more if you have it. In my private consulting, I spend 90 minutes, in the clinic, it’s 60. That’s what the insurance reimburses, but 60 minutes minimum. You’re looking at the patient’s history. You need to know okay, what kind of medications are they on. Very often, well look up medications with patients and show them. I’ve had patients come in on statins, and I know I’m going to talk about that in a little bit, that had such leg pain it was horrendous and it’s because of their statins. I can’t wave a magic wand and eliminate a side effect from a medication, but they need to be aware of that. That’s all part of that informed decision making thing. I need to know their history. Have they had any accidents? Have they had injuries? And I don’t care if it was 20 years ago. I had a guy once who came in, he’d had about eight or nine PT treatments, and it was conventional, right. He was getting ultrasound and hot pack and range of motion - and I could never figure out doing range of motion can fix anything, especially if you’ve got neck pain. How is that going to fix anything? So he ended up on my schedule because his therapist was on vacation, and so I questioned him. He’d had eight or nine visits with no change in symptoms whatsoever, and his symptoms were severe neck pain and headaches and they occurred when he was doing his morning walk, which was his favorite exercise. He didn’t want to give up the exercise. He wanted to do it, but by the end of it, he had neck pain and a headache and he wanted to get rid of that. So I told him, I said well, what’s been done hasn’t helped you. Are you open to trying something else? He was very open. He wanted to fix it. So I looked at the lower back, because the spine is one piece of anatomy, right. I know they’ll break it up – it’s cervical, thoracic, lumbar, sacral – no, it’s all one piece. So I told him how the lower back can affect the neck and would he mind if I looked at the lower back, he didn’t mind. I did some simple little mechanical corrections, but I didn’t think that was it so I started questioning him. [unclear] Okay, you get this when? And he was telling me it was when he walked and because of my knowledge of how the body works and everything’s connected to everything else, I advised that I bet he’s not dorsiflexing properly, which will create a strain right up the back of the leg, the spine, right up through to the neck. So I asked him, have you ever sprained your ankles? And he said he’s sprained them countless times in college. He lost [unclear] from spraining his ankles. So I looked at his ankles and he had no dorsiflexion and it think it was like minus on one, he was stuck in plantarflexions, so that’s going to force him to hyperextend everywhere else. So I mob’d his ankles and showed him how to do a good stretch to lengthen the gastrocnemius because of the
was pretty tight, and he never came back because the problem was fixed. So think about it. This man had neck pain and headaches because his ankle was not dorsiflexing properly. Now had he gone on with that conventional PT treatment, he would never have gotten better, his structures in the neck would have become damaged or injured over time. He could have ended up getting injections. He could have ended up with surgery to his neck. None of it would have fixed his problem. So that’s where a manual PT comes the neck would have become damaged or injured over time. He could have ended up getting injections. He could have ended up with surgery to his neck. None of it would have fixed his problem. [unclear] So that’s where a manual PT comes in. We are looking at the system, right, and we address the whole body by looking at it. So it’s not that I’m going to work somebody from head to toe when they walk through the door, but I’m going to figure out what’s causing the problem and address what’s causing it. I’m not going to beat up the victim.
Dr. Maya Novak:
Yeah, this is such an important topic because many times we don’t think that some other body part can actually affect and cause pain, so yes. I have a lot of experience with ankle injuries because I fractured my ankle terribly six years ago. So many people find me through my story, my ankle recovery story. But it’s so true, if, for example, you’re not working on the flexibility of your ankle, you can experience pain in your knee, in your hip, in your back, in your neck. Everything can be out, right?
Yes. And to add to that, I had a young football player come in from the local college and he had a diagnosis of tendonitis shoulder and elbow, right. His pain was when he was throwing the football during practice. So I’m looking at this kid, he is solid muscle. Solid muscle – he was like a brick wall from head to toe. There was no weakness in this kid. He had a full range of motion. I say kid, he was 22 - but he had full range of motion everywhere. There was not one thing wrong with his shoulder or his elbow. So I said okay, show me how you throw a football. So he throws a football, he releases it, and I notice his ankle was unstable. I said how many times have sprained your ankle. He said it happens half the time in practice and so I have to walk it off if they roll out. Of course, internally I’m thinking what is wrong with your coach and your trainer. Why are they not making sure your ankle is stable? You’re a quarterback for crying out loud. I didn’t say that, of course. I just said okay, there’s nothing wrong with shoulder, we need to start with your ankles, and we worked specifically on stabilizing those ankles. [unclear] Then people are like well how can happen, and it’s like well, you’re muscles eccentrically lengthen under tension to control the motion and keep your arm from flying off your body so it just stops. Now if that ankle keeps going, the shoulder goes beyond where it’s supposed to go when you release the ball. So now, it’s getting, right? So I never touched his shoulder, never touched his arm. I had a couple of sessions to stabilize those ankles and he could practice for hours throwing a football and not one stitch of pain anymore.
Dr. Maya Novak:
So ankles are key, but they have to be stable too and not just move.
Dr. Maya Novak:
Yes, true, very true. So a couple of weeks ago when we were talking about what we could potentially explore in this interview, I asked you and shared with you – I don’t know if this is also your experience – but I hear so many times that doctors are not advising people to go a PT, and you said yes, that’s my experience as well. So what would you say to someone? Because this is not something that just happens every so often. I’m getting this type of information like every single week. So what would you say to a person whose doctor feels they don’t need physical therapy, that maybe they just need to walk it off, or just wait, or do a couple of exercises at home. What would you say to this kind of person?
Well first, I’d like to briefly address the reason that it’s not prescribed or recommended, okay. My profession has done a really poor job at educating the public on what we do and why we’re important. You ask anybody who walks down the street what PT does, and most of them don’t have any understanding and doctors are pretty much the same way. They don’t really know what we do. They think we do massage or just exercise. They don’t really understand that we’re trained basically on an entry level when leaving College to adjust every area of the body where problems can occur, and then most of us will go into a specialized area. Like wheelchair fitting for disabled, or geriatrics, stroke, rehab, that kind of thing – pediatrics, neurological, brain injuries – the list goes on. So you need to find a PT who is trained in your area of need, right, because it is a diverse field. And then there’s also the issue where – and I personally know several orthopedists in this area who are extremely skilled orthopedists who have no respect for physical therapy because they’ve seen – and they’ve seen the results of the cattle places, right. They don’t realize there’s a difference. Also, when I did acute care, there was one physician who commented about PT in the hospital setting saying if you spend 10 minutes with them that’s useful. Now, in all fairness, somebody who is 85 and they’ve just had surgery and you get them up out of bed for the first time, 10 minutes is all they can take! So that’s a little out of context, but there’s a need for us to educate the medical world in what we do, for one thing. But I would tell a patient is I would say you need to be your own advocate. You need to ask for physical therapy. Now in my country, I believe pretty much all of the States, I don’t know if there’s any States left where there’s no direct access. I think pretty much all the States now have direct access so you don’t even a doctor’s prescription to seek out physical therapy. But then you have to check your insurance because some insurance companies won’t reimburse if you don’t have a prescription from the doctor, so there’s that. And direct access is limited. In my State, it’s 10 visits without a prescription. So there’s all of those things too. You need to ask. I’ve had patients come in and say my doctor told me I didn’t need therapy, and I said yes you do because I know you, I’ve worked with you before, and I told them. I said no, I know somebody who’s going to fix me and I want to go see her. So I’ve had people demand from their doctor, and I don’t mean rudely or just not leave the office until they get a prescription for PT if they need a prescription. I know patients who were - I had this one patient, she had been injected in her shoulders for five years when I consulted with her. I asked her did the doctor ever recommend anything else, PT, or anything, and she said no. So I don’t know if some of it is just they truly believe that what they’re doing helps the person and they don’t think there’s anything else to offer. I’m not quite sure. And I say potential ignorance, and I don’t mean that as an insult, here it seems lack of knowledge, right, lack of facts. But people need to be their own advocate. They need to ask.
Dr. Maya Novak:
Yes. You mentioned that – I don’t know how it is around the world – but many times it’s like 10 sessions and then the insurance doesn’t cover it anymore. So what do you do if a person does need more than just 10 sessions? Which is usually the case with serious injuries. What do you do in that situation?
Insurances are quite diverse, so I’ll briefly share a little bit about insurances. Medicare covers 10 visits at a time, which means that if you can show that the patient has not yet met their goals but they have shown progress, you can get 10 more visits. That can happen sequentially. Obviously, the chart will get audited if you go over. If you’re doing 30 or 40 you’re going to get audited and more than likely, they’ll decline in the end because they’ll see that that’s ridiculous. Then there’s workers compensation where you’re jumping through hoops three weeks at a time and people get gaps where they’re not even being treated for a couple of weeks waiting for approval for more treatment. Which is insane and drives me crazy because that sends people backward when they don’t have therapy and I just like want to go to their house and help them. Then there are those who have some very strict insurances and the insurance will only give what the therapist requests on the initial form that has to be filled out. I could request eight and they might give four, right. Then you have to request again after the fourth, so it’s nonsense, absolute nonsense. Then you have people who say they have Medicaid. I think they just changed it this year to 40, but up until this year, 2019, it was 20 visits per year maximum. It did not matter if they had surgeries, injuries, accidents, they got 20 visits per year and was it. So what I tell people is, it’s interesting how we are obsessed – and I don’t say this as an insult – but we are obsessed on making sure that whatever we see out medical is covered by insurance. It didn’t use to be that way. It didn’t use to be that way at all. People would pay out of pocket for things. I liken it to the insurance on your house. Most people have homeowners insurance so that if serious things occur you’re covered. But when it comes to maintenance, the insurance isn’t going to pay if you need to replace your windows. The insurance isn’t going to pay if you upgrade something or you put an addition on, and we expect that. So when it comes to our bodies, we’re so obsessed with making sure insurance covers it, and then if it doesn’t cover it we just okay, well I guess I can’t go anywhere – and that’s insane. The average person will go out to dinner and for two people it’s nothing to spend $70 or $80 to go out to have a nice dinner, but they won’t pay $70 or $80 for a PT session. That’s insane. I understand there are going to be some people who are financially not able to do that, but for the most part, your health, your body, your physical function is so important. I don’t think we should stop taking care of ourselves because insurance doesn’t cover it. I don’t think that’s a good enough reason.
Dr. Maya Novak:
The person is usually in pain when they come to physical therapy. Are there any risks when it comes to pain management? I mean there are many, of course, benefits in regards to “I’m not going to feel any pain” but are there any risks?
Yes, there are lots of risks and part of what I spent a great many years educating myself on so that I can inform the patient and those who come to my classes and lectures and talks.
Dr. Maya Novak:
We'll continue in just a moment. I wanted to quickly jump in for two things. First, thank you for tuning in. And second, I’m sure you have at least one friend, colleague, or family member who would very much appreciate this episode. So share it with them and help us spread the word. Now let’s continue…
A lot of people aren’t aware that different medications can be quite harmful with side effects. Acetaminophen, that’s one of the biggest things that people will take if they have pain and think oh, it’s relatively harmless as well – not so much. The interesting part is, is that the data doesn’t even back up that it’s effective. The data shows that acetaminophen is useless for lower back pain, for hip pain, for knee pain. And I think over half the acute liver failure occurrences that occur out there are due to the overdoses of acetaminophen and that’s people taking it properly, right. It’s in over – at this time and I haven’t updated it recently, but the last time I looked which was about a year ago – over 600 over the counter and prescription medications include acetaminophen. So it’s easy to overdose without realizing it if you’re using more than one medication at a time from both over the counter and prescribed. My own father, he passed at 93, and the only medication that he was taking was Tylenol or acetaminophen because he had joint pain. He was 93 and the goal was to keep him comfortable. He did have CLL, which is Chronic Lymphocytic Leukemia, which he had been asymptomatic for years but it finally got a hold of him and started becoming symptomatic so he was basically at end of life and the goal was to keep him comfortable. So he was given around the clock acetaminophen so that he would not experience a lot of joint pain and discomfort and that kind of thing. But because of his age and his medical, his liver was not able to detoxify the medication. He wasn’t over prescribed. I think it’s eight, but don’t quote me, I think it’s like 800 milligrams a day is the maximum dosage and he was getting under that, so they did nothing wrong. I don’t hold anyone to blame, as a matter of fact, I had told them please keep him comfortable, and I was there, obviously, constantly visiting at the same time with him. But he turned yellow a few days before he died. His liver had overloaded on the acetaminophen. Now I don’t know if that hastened his death or not. I don’t know. He had the CLL, he did have heart issues and that kind of thing. But it’s very easy to overdose on acetaminophen unknowingly and if you have any compromised health conditions even more so. And then you’ve your NSAIDS, right, your non-steroidal anti-inflammatory drugs - ibuprofen, Advil – those kinds of things. A lot of people live on them. As a matter of fact, they put those – athletes – they’ll put little ibuprofen samples in their little bags whenever they’re running in events and things like it’s just this natural thing to take. Well, yeah, exactly. Now, it’s not supported for long-term use in the data because of the risks and the side effects. So, people who have chronic pain or if you’re recovering an injury like you said, it can take a long time and now you’re going to be living on that NSAID for how long, right? The list of the GI bleeds are huge and death from GI bleeds. I think like 100,000 deaths a year are from GI bleeds alone, and that’s a low number. You’re also at risk of developing cardiovascular issues, AFib. Those are all related to chronic long-term side effects. I tell my patients I don’t even want them taking their meds before they come to see me because if we’re doing something that’s increasing their pain I want to know about it. If you’re medicating your pain and you’re using a body part, you’re causing more damage without knowledge and nobody wants to do that. You want it to heal and repair. We don’t want to injure. So it’s very important. Opioids, of course, we all know that’s like – you could do an entire Summit on opioids, right. I attend our opioid coalition in Rensselaer County here, there’s meeting every few months. As a matter of fact, we’re going to have a stigma event – getting rid of the stigma of people on opioids. Because the majority of people who end up addicted to opioids and getting heroin out on the street is because it started with a prescription for pain because of an injury or surgery. So these people are at extremely high risk. Now they’re doing their best. They’re monitoring doctors now and if they’re over-prescribing, they’re getting dinged for that. Some, I think, have even lost their license for that. They’re also – they used to give people 90-day prescriptions after a surgery. Now the law says they can only give them a seven-day prescription after surgery. I know myself. I had some oral surgery done, they kept trying to push the opioid on me, and I was like I don’t need it. They said oh, but you’re going to – it was so funny. I really had to stand up for myself and say I don’t want it. I don’t need it. I had slight discomfort. I took like one ibuprofen and I was fine. It’s craziness. We’re so afraid people are going to have a little discomfort that we’re over-prescribing these pain medications. But opioids, the interesting part, what people are completely unaware of in general is that when you compare an opioid to other pain medications, opioids are not as good as other pain medications. The population out there thinks that opioids are the strongest pain med on the planet. It’s not true. The data doesn’t support that. When they compared opioids to a combination of NSAID and acetaminophen combined, the NSAID/acetaminophen combination was actually more effective at addressing pain in the population. So why are we even prescribing them, right? Then when you look at the data on how effective opioids are for pain, there are no well-done controlled studies that are longer than three months. So long-term use, not a good thing. There was a great study done in Denmark and what they found was chronic opioid therapy – COT – for people who’ve been on it for a long time - ended up having higher pain levels, poorer quality of life, and less function. So it’s not a good then... [unclear] Then lately, we’ve been moving into the antidepressant category to address pain. Now chemically, biologically, anatomically, and physiologically nobody knows how an antidepressant addresses pain. So they’re prescribing something without understanding the mechanism by which it’s working. There’s a very high dropout rate in the data studies because of all the side effects of the antidepressants. And typically, for people’s symptoms, the number needed to treat is eight and what that means is you need to treat eight people in order for one person to benefit at least 50%, right. So a number needed to treat eight equates to being about 13% effective in addressing pain - and the side effects of antidepressants would take another Summit. If you read Dr. Peter Gotzsche’s work, they are neuro toxics and they are highly damaging to the body and to cognitive function - so not a good idea for pain relief.
Dr. Maya Novak:
So that’s just the medications, now we’ve got injections, okay. Cortical steroid injections are very common. As I said, that one woman was getting injections for five years. The interesting part that I didn’t say when I mentioned that woman was that I did one manual therapy session with her. This was a woman who had severe pain who could not lift her arm. She had a posterior sacral torsion which was pulling down on the shoulder, so we did muscle energy to correct the torsion. We did strain counter strain to calm down the lat so that it wasn’t pulling her shoulder out of alignment abnormally. She had full range of motion with no pain in a day, after five years of injections for her shoulder. And she was elderly. She was in her seventies. So a lot can be done, right. So let’s talk about injections. Injections are very common. I’ve had many people come into the clinic who they went to an orthopedist. The orthopedist did the injection. It didn’t work, so then they sent them to therapy. Now, of course, I question my patients always and say were you fully informed of the risks and the benefits of what was advised for you, and I don’t say it like I’m attacking the doctor. I’m just trying to open up their mind to that whole idea of maybe I should ask some questions before I say yes to this, right. And every single time, I’ve not had one patient tell me that a doctor told them there were risks involved when they recommended a cortical steroid injection. Not one, and that’s very scary. Very scary, right. So the cortical steroid injections, the risks, the side effects are the death of nearby bone – osteonecrosis. Osteo being bone, the crosis being death. So you’re literally killing off bone cells. You can get an infection. You can get nerve damage. The cartilage can be deteriorated. The tendons can be weakened or ruptured. You can also get thinning of the nearby bone, osteoporosis. Then the studies – one study did a study two years ago and what they found when they compared the steroid injection to a saline injection, which is just salt water, the steroid injection created cartilage volume loss – so you’re decreasing cartilage and there was no significant decrease in pain between that and the placebo of the saline. There was a study done on shoulder impingement with cortical steroid injections versus manual PT. The interesting part is the manual PT was only for three weeks – two visits a week for three weeks, or it might have been three visits a week for two weeks, but it was six visits and that was it - and then the people who got the injections. They were followed for a year and throughout the year there was no difference in – they both worked for pain, okay. But the difference was at the end of the year, the people who had just had the injection and no manual PT had seen all kinds of other clinicians, physicians, and had other procedures, other things done. Versus the manual PT, that was all they had. So it was very, very effective. So when it comes to injections, I would say let’s try something that doesn’t have those risks attached first, right. And then there’s medical imaging and, of course, pain management is all about let’s image it – let’s see what’s going on – and I’m not saying that’s a bad idea. The problem lies when we think of the reason you got the problem is actually because of what we see on the image. Because it’s fascinating how often the imaging and the symptoms do not line up. For instance, there was a village that was studied for rotator cuff tears and what they found were like 660 people in a village and they found about 150 of them had rotator cuff tears. The interesting part is only about 34% of them actually had symptoms, right. So that means you had over 65% of them with rotator cuff tears who had no symptoms – that means no pain, no limited function, no limited range of motion, and it was age-related. The population in their 20s didn’t have any tears. The population in their 80s or 90s had most of them, that kind of thing. But I find it interesting that all those people had tears and had no symptoms. So my point that I’m making with this is if you have shoulder pain, they do an image, and they find a tear, everybody’s assuming that the reason you have the pain is the tear. But if people can have a tear and have no pain, our assumption might be faulty. And as we talked earlier, you could have shoulder pain because your ankle is not stable. You could have shoulder pain because you’ve got a torsion in the lower back and it’s pulling lat dorsi and pulling that arm out of alignment and every time you use the arm, it’s not happy. So you could do surgery there, but is it going to fix the torsion and that lat dorsi, no. Right? Then you’ve got medical imaging on knee pain and just as often miniscule tears have no symptoms as those that do have symptoms. A lot of the times the reason people have knee pain is because of an ankle that’s not functioning well, or a hip that is not functioning well on all three planes of motion and has lost mobility, right. So people don’t realize this. I mean if you’ve got knee pain going up stairs and it’s not bone on bone, oftentimes just switching on those hip muscles will eliminate the knee pain because it’s got nothing to do with the knee and if they go to the conventional PT, they’re going to beat up their knee, and then not address the hip, right. There’s other imaging for the cervical spine. I think about 70% of the subjects in one study were in their twenties, so they were young, had cervical spine disc fault and no symptoms. So again, okay, if you can have those things and not have symptoms, why are we assuming that because you have those things that’s what’s causing this. It may have nothing to do with it. The same thing with lumbar spine – about 20-25% of the population have lumbar spine disc faults with no symptom and no pain. About 60% of the population can show degenerative changes with no pain. There was a great study done by a doctor at the Cleveland Clinic on herniated discs and about 15% of the subjects herniation improved, literally resolved, and about 13% of their herniation worsened and there was no – it didn’t matter whether or not it worsened or improved based on their symptoms. In other words, a lot of them, the herniation improved and their symptoms worsened and then if their herniation worsened, their symptoms improved. It didn’t line up. [unclear lodging/bulging?] So we’re just assuming. All of this imaging that we’re doing to people could be really faulty, right. So lots and lots and lots of data, x-rays, cast cares, MRIs, consistently show things like a herniated disc, subluxations, scoliosis – that’s huge, I’ll talk about that in a moment – osteoarthritis, pinched nerves, right all these things. But they appear unrelated to whether or not somebody experiences pain.
Dr. Maya Novak:
This is so extremely important, everything that you’ve shared. When you talk about steroid injections and depression medication and pain medication and everything – like you said at the beginning, it’s really important for the person to be their own advocate – but also to do their research. Because if you have a person in a white coat, it doesn’t mean that they, of course, have all the knowledge. Plus, you have to then take the responsibility for your own health. What you shared here in regards to steroid injections, two years ago I was diagnosed with hip bursitis and, of course, the PT told me if you’re not going to get steroid injections you’re not going to get better. I did my research and I discovered there are so many risks. I don’t want to have those kind of problems in five years. I politely declined. She wasn’t happy with that, but it’s my body and I’m responsible for what is going to happen. I mean it’s me who is going to live with pain, for example, or osteonecrosis, or whatever. So what you covered here, I hope that people are taking lots and lots of lots of notes because it is important. And if I may just say something about opioids, I know how difficult it was for me when I was getting off of them after the surgery, and thank goodness that there was a nurse who told me that he injured his ankle, I think a year before that, and that opioids are really strong stuff. The symptoms are horrible and if I hadn’t known that I would have thought that something was wrong in my mind because I was crying, and I was impossible, and the worst thing was I wasn’t able to run away from myself. It was horrible.
Dr. Maya Novak:
Yes. So thank you for covering this.
Yes, I just want to emphasize when you say when they diagnosed you with hip bursitis I have a little issue with a diagnosis being itis of any kind because, to me, it’s a symptom. You had bursitis, or maybe you had tendonitis, right. It’s the greater trochanteric, it’s where all those big muscles to the butt and the hip attach to the side of the leg bone. So it’s craziness. Because we had a student one time who was mentally a lit bit less than energetic, and so she came in to me one time and want to know what exercises she should give a patient who had trochanteric bursitis. I looked at her and said well, you need to figure out why she had that and she looked me and you could tell she wanted to roll her eyes because she just wanted me to tell her, give her abduction, give her flexion, give her tension, give her … right? I said you need to figure out why does she have the bursitis. What is out of alignment that is abnormally pulling on that area creating inflammation. We need to fix the problem, not treat the symptom.
Dr. Maya Novak:
Yes, and it’s not just about doing an exercise and it’s going to make you ok.
Dr. Maya Novak:
Because just the exercises, or doing just five exercises, for example, it’s not going to cover everything. We are talking not just about your body and what you are doing physically. We are also talking about nutrition, what we are thinking, and everything. So in regards to itis, can we talk a bit about inflammation? What inflammation is?
Yes, okay, so people often get the diagnosis of bursitis or tendonitis, right. It’s very common. So typically, wherever there might be an area of weakness of asymmetry or something that’s not even on one side versus the other side of doing for the entire body, the whole parts and things like that. But there’s also this underlying chronic inflammation that the majority of the population has unknowingly because of how they’re nourishing their body and they don’t realize how important food is, right. So food is huge. It’s huge and I say it’s the number one thing that needs to be addressed whether you’re recovering from an acute injury, or have chronic pain or any other diagnosis. If you are – I joke when I do my talks and say if you’re seeing more than four clinicians, I think nutrition is probably your answer, right. So we really need to be paying attention to that. So what a lot of people are unaware of is that food can promote inflammation in the body. It’s interesting because it was the Stanford University School of Medicine who decided to figure out why joints break down, right. Why do osteoarthritis and those kinds of things occur in your joints? What they found through their studies is that it was not wear and tear. It was not compression, right. It wasn’t gravity and age. It was chronic inflammation. What causes chronic inflammation is food. Absolutely food and we’ve become a society worldwide, I think, where food is – it’s either a – it’s become this luxury, oh I’m going to treat myself, right. It’s become this obsession, it’s all people think about sometimes. I don’t know – I think we have taste buds for a reason, we’re supposed to really be enjoying our food, and I think that’s wonderful, right. But I don’t think it should be entertainment all the time either. I think we should eat so that we can live well. We’re not living so we can eat well, right? There’s that mindset, which I know we’re going to talk about. But I think people are completely – have no knowledge of the fact of how food promotes inflammation. One of the ways is arachidonic acid. There’s something called arachidonic acid and the body will create arachidonic acid. It will create all it needs from plants. So we don’t need to be consuming it, but when we’re consuming animal foods, oily fish like salmon and those kind of things, and it doesn’t matter what it is – chicken, fish, seafood, whatever, they all have arachidonic acid. According to the USDA standard database, those are the highest in arachidonic acid. So when you’re eating a diet that’s very high in animal foods – and I’m not using the “V” word. I’m not saying people have to be vegan, okay, because everyone runs away and doesn’t want to hear what you have to say. But the point is, the more animal foods you consume, the more arachidonic acid you consume and arachidonic acid promotes inflammatory chemical responses in the body. It’s sort of like your healing and repairing mechanism is going on all the time, because we always have cells dying and we have cells being made and that kind of thing. So we’ve got this system happening constantly, but it shunts itself. It reverses, it turns itself off when it’s not necessary, especially if there’s no injury going on. Well now, when you have an injury, and that is on and you’re promoting it with more chemical mediators being created by the body, now it’s kind of like a brick on the gas pedal. It can’t turn itself off. It can’t slow down. It can’t do anything. So you’re healing. You’re repairing, but that chemical mediator response is still at high alert and so now you’ve got this chronic inflammation in your body and it can create a great deal of pain. There’s a huge body of evidence that relates chronic inflammation to meat, absolutely.
Dr. Maya Novak:
So how can we affect that pain with food choices and what we are putting into our bodies?
So the best part is plant foods have little, or no arachidonic acid. The body will make what we need from those plant foods. So the more whole, fresh, live plant foods we’re putting in our body, the more we are fighting inflammation. The less animal foods - and then baked goods have a moderate amount of arachidonic acid. The nice thing that the entire world is in agreement on, that nobody thinks a donut is a health food, right. So we all agree about baked goods. There’s no argument there and that’s kind of nice. But the whole thing about the animal foods – I mean you can just minimize your animal food intake – two or three times a week cut from two or three times a day and you can see a huge difference. I teach nutrition classes at the local community college and I feed people. I feed them a four-course meal because people think eating healthy is boring. They think they’re going to have become a cow and just munch on a bunch of grass, right. They get a four-course meal. They’re eating soup, salad, dinner, dessert and everything is completely animal-free and completely delicious. I have so many people who come up to me and they go, I stuffed myself and I feel really good. I usually just like want to go to sleep, I want to take a nap, I want to do this, I feel so good. And usually, and this is the best part, their faces – the smiles on their faces are priceless. But within one week, I’ll have people tell me I can’t believe how much less pain I have. It’s phenomenal, phenomenal.
Dr. Maya Novak:
And that’s really, really important information - that it doesn’t take a year to feel the change. You really feel the change in a matter of days, or sometimes a week, two weeks. It’s not like now you have to suffer, and then maybe one day in the future you might feel differently. When it comes to this, you probably have even more experience, but I do have some experience with our client base and their food choices and how fast people see – like in five days from not being able to move their arm to being completely functional just because they took away what was causing that extra inflammation, right.
Right, and two quick examples. I had a couple in their eighties come to one of my nutrition classes. Now, she had extensive hip and joint pain and arthritis – walking with a cane – and she told me as long as she follows my regime – she calls it a regime – that she had no pain, in her eighties. Another person, a coworker, who had serious elbow pain, was told he was going to need surgery on his elbow when he was sick of the pain. I came into work one time and he says watch this, and he took a softball and he threw it as hard as he could against the wall and I’m trying to figure out why he’s me showing this. He said no pain. He said I haven’t thrown a ball like that since high school. Now for him, it took a little longer because he had a lot more damage and inflammation in that elbow. And then he went on a vacation, and he ate a whole bunch of garbage that is not normally on his diet because he was on vacation, and he had so much pain he couldn’t take enough ibuprofen for like a week because his elbow was killing him. He says never again. The next time he went on a vacation, he goes I’m not going to do that to myself twice, that’s it. So he didn’t want that pain back. He saw that direct relationship, absolutely.
Dr. Maya Novak:
I usually explain to people that in regards to injuries, this is your weakest link, and you’re going to feel the change really fast in the part of the body that’s injured. Later on, it’s going to be really hard to notice it. This is where this chronic inflammation comes in, we are not aware of it if we have it, but when you’re injured that’s the weakest link saying hello, I’m here. You can feel it more, right?
Absolutely, and then there’s also impaired circulation. The last thing we want to do is impair our circulation when it comes to the healing process, right. Because that fresh blood supply brings all the nutrients. It brings the oxygen. It brings everything we need and it takes away the toxins and the carbon dioxide, and all the nasty stuff we want to get rid of. So if we’re impeding our circulation, that’s going to affect injury. High-fat foods, oils – all oils – and I know everybody listening to this is going freak out because I’m tipping over a sacred cow here, but olive oil is just as bad as canola oil, it’s just as bad as motor oil. I mean there’s no such thing as a good healthy oil. We’re not meant to consume oils, it’s essentially fat and calories. I’ve had people tell me I can’t lose weight and I’m like well, give up the oil. You can gain 36 pounds a year if you add olive oil to your food and don’t make any other sort of changes, and they’re like what? There’s lots of extensive research on oils and circulation. I could paper the walls in my home with how many studies show that circulation is adversely affected by consuming oils. So it’s not a good idea. And what they’ll do is they’ll damage those little cells that line all the blood vessels, the endothelial cells. Those endothelial cells have lots of jobs, very important jobs, one of the most important being that they produce nitric oxide, which dilates the blood vessels, right. So if you impede their ability to do that, those blood vessels can stretch. And the capillary, which is the tiniest blood vessel in the body, is only made up of endothelial cells. That’s what it’s made up of, that’s it. So if those cells are damaged, right - I’ve heard experts say you’re only as healthy as your sickest endothelial cell – and we have miles and miles and miles of blood vessels in our body. Everybody is worried about their heart and their brain, but what about the rest of the body – especially the spine? A doctor from Finland has done extensive research on impaired circulation to the lumbar arteries and chronic back pain. She’s done – there’s three main branches to the lumbar artery, and she’s actually determined through studies that which branch is impaired affects what symptoms you’ll have – whether you’ll have deep hip pain from exercise. Whether you’ll have degenerative disc disease. Degenerative disc disease is a lack of blood supply to the spine. It’s not gravity. It’s not aging. It’s blood supply. So if you’re going to have injury repair, you need blood supply, so stay away from the oils. Stay away from the fats. You need to be making sure that you’re eating lots and lots of lots of good, wholesome plant foods.
Dr. Maya Novak:
Yes, and that is why it’s necessary to address different areas when it comes to recovery. Because otherwise,e we have back pain and then you go to a person who specializes just in the exercises, do these exercises, and then it doesn’t get better. Or it might improve slightly, and then it is reversed because the problem might be in the diet and then circulation as you just explained. Goodness, I’m enjoying this extremely, thank you so much for sharing.
Dr. Maya Novak:
But if we’re talking about pain and decreasing pain, what are some other options if we are not talking about food and food choices? How can we decrease pain?
Yes, so obviously food is key. I use a four-prong approach when treating my patients. I’ve been consulting all over the world with people. So don’t even have to put my hands on people. I don’t even need to do manual therapy because self-care treatments are just as important and teaching them how to fix themselves is key, right. Teach a person to fish, right. So nutrition is key. They’ve got to have that right if they really expect to do their best. Then the next step would be okay, let’s address how the body is functioning. Let’s deal with can you move in three planes of motion or are you limited? Where is your mobility not what it should be? Is your hip rotating properly or is it not and that is why your knee is not healing correctly, or why you injured it in the first place? We already talked about ankles – mobile and completely stable. The hip has to be mobile and stable. The rib cage, the thoracic spine, has to be mobile. It’s fascinating how often somebody has low back pain or injures themselves because their thoracic spine lacks rotation. So every motion we do throughout the day requires three planes of motion. We move forward and back, we go side to side, and we turn left and right. So if we’re not able to accomplish one of those planes well in a major body area, it’s going to affect the entire body. Everything is connected to everything else. So when I assess people there are three planes of motion I test in, and there’s to motions for each so I have them do six motions and I have them do it on each side of the body. We see. I’ll look. You can’t externally rotate here, you can’t abduct here, you can’t either here – let’s address these and let’s see if that doesn’t resolve your issues. I had one guy come in, he was 18 years old, he had knee pain, and a lot of the times, just switching on the hip will stop knee pain. So when he stepped forward he had knee pain. I said okay, let’s have you rotate. So he stepped forward and he rotated, and he was like I just got really big moves, how did you do that, that didn’t hurt? He couldn’t believe how it just switched off the pain. I said well, your hip wasn’t properly and we got that hip working. So he thought it was like a magician, right. He was a sweet young kid, and I know we’re going to talk about mindset in a minute, but had very a very negative speech. He was 18 years old, oh yeah, I’m going to end up with arthritis, and I’m going to end up with that. And I would go sh-sh-sh, none of that talk here. You’re speaking death into your future, cut it out, it’s not allowed. So the next time he came in, he was really quiet and I said why are you so quiet? He said, well you told me I couldn’t say anything negative. I said, so you can’t think of anything positive to say. That doesn’t mean you can’t talk!
Dr. Maya Novak:
So anyhow, making sure the body moves in all three planes of motion. Then there’s the neuro fascial system, which a lot of people aren’t familiar with. The neuro fascial system is how your brain and your body connect. Your connective tissue is the most abundant tissue in the body. It’s highly specialized. It’s got more neuro cells embedded in your brain, and it’s what tells your brain where you are in space. Most of them are embedded in the joints. So the more joints you get involved when you’re doing an exercise and not isolating a body part. That is one of my – I hate to use the word pet peeve – but it’s one of the things that annoys me the most is somebody is taught to isolate a body part. For one thing, it’s physiologically impossible. You cannot isolate a body part. In order to do this, my core is stabilizing me. So I can’t even isolate this motion without other things being involved and firing. So you can’t isolate anything and when we function in life if we’re performing in sports, when we’re doing anything physical at all, our entire body is involved. So when we’re exercising, when we’re rehabbing, when we’re strengthening, we need to have the entire body involved. That is the best way to train it, so I teach people that. But that connective tissue is huge and there’s ways to access that. There’s ways to lengthen, hydrate, and decompress those areas where to where a person can treat themselves. Then another thing is if the body is very asymmetrical. In other words, you have one body part working a lot better than another body part. And often times this is the case of an injury, and also from surgery, and even just life. You have people come and they’ll say well yeah, my right side of my body always has problems. Well, my goodness, you’re going to be compensating every single physical task you do throughout the day if you’ve got a whole side of your body that’s not working the same as the other side. Or even just an arm or a leg – if your right leg is stronger than your left leg, or if your left shoulder has less range of motion than the right, you’re going to be compensating. So there’s a great way to address this, to improve the symmetry of the body so that the body is not compensating all the time.
Dr. Maya Novak:
Yes, because if we do not address compensation, things don’t get better. Like what you were saying just at the beginning when you were talking about that man who had problems with his neck, but the problem was the ankle.
Dr. Maya Novak:
He was probably compensating as well because of that, and not even aware that the ankle was the problem.
Dr. Maya Novak:
It’s so extremely important. Now, what about if a person has already tried it all? If they’ve been to five physicians, 10 physiotherapists – I know that I’m exaggerating – but let’s say that a person tried it all. What is your approach with a patient like that?
Yeah, so. Well, I think I have a perfect example, and the reason I use lots of examples is people relate to stories a lot better than facts. Not that it’s not factual, but. So I had this man come and talk to me who wanted to consult with me and he was very reluctant because he had – what happened, his history was bad. No one had ever been able to fix his back pain, but it had diminished enough where he was able to function right, okay. So he had injured, I think three or five years – I forget which – I know it was at least three years – and it had never really resolved. He was contacting me because he had experienced acute onset of severe right hamstring pain. Now, this was a guy who was in his sixties, but he was extremely active. He played lots of volleyball, a very physical sports oriented person who never stopped. So this was radically affecting the quality of his life and he was very upset about it. He’d been seeking out all these different people. He’d gone to a local PT, he’d gone to expert specialists, chiropractors, this one, that one, and the other one, injections and all kinds of nonsense and nothing was working. So he contacted me, I think out of desperation because it’s long distance, right, it’s over the computer. So I assessed him through the six motions that I talked about. I talked about different things. We addressed the symmetry, the asymmetry. Obviously, his right leg was not working the same as his left leg. But also, he had some differences in his trunk rotation. He had some differences there. I mean just trunk rotation can create abnormal changes in the body. So I gave him some homework and here’s the interesting part, and this might surprise you because there’s no happy ending to this story that I’m sharing. He had tried everything and was frustrated, so I gave stuff to do and he was to let me know. Well, I heard from him three weeks later and he said that it wasn’t working and should he keep doing what I’d told him. I said well okay, what have you been doing? Because I’ve learned over the years people don’t always do what they were told. They mix it up, or they confuse it, or they miss something. So he’s telling me what he’d done and I said well, what about this? Because I looked up on my computer what I had given him, and he said I don’t have that. I said well I emailed to you. It was to address the asymmetry in his body. He said I didn’t get it. So I’m checking the email, the sent emails, I go it went to you. And then he goes oh, here it is, I missed it. Okay. But I should have practiced this with – I had to listen to a 10-minute tirade on why should I be the best to help him, everybody else has promised to fix him and he has tried everything, nothing has worked, why would I be any different. Well, he didn’t do what I had told him to do. He missed almost half of the advice that I gave him and the recommendations. So I said work on those, see what happens, and then get back to me. I haven’t heard from him. [unclear] But sometimes people have tried everything, they get so frustrated, they get so angry, they’ve spent so much money and they’ve jumped through so many hoops and run around in circles chasing their tail and they get nowhere. I think they kind of get [unclear hopeless?]. They’re a combination of desperate and
and that’s not a good place to be. I think the most important thing to do is to get your mind right and stay in that place because, you know, James Allen wrote As a Man Thinketh but Wallace Wattles has some great stuff on how we think. It’s very old, old writing. You can get it for like 99 cents on your Kindle, but it’s fascinating. I mean I stayed up all night long reading that. The man knows what he’s talking about when it comes to our mind and how it affects our physical. Not only our physical abilities but our physical health. There are a lot of experts out there who have shown, like Dr. John Sarno. A lot of work about how the mind can keep us from healing and actually create pain and chronic conditions that won’t go away. Those are those people who’ve tried everything and nothing works, right. Jonathan Kuttner, he’s a brilliant physician from New Zealand who has a book on – I think it’s called You Pain Free – he changed the title after it first came out, so it’s a different title. He quotes John Sarno, but he also comes up with some other terms. There’s hyperalgesia, there’s all kinds of different reasons why people don’t get better. I think they get tired of searching and they get tired of wasting their time. They get tired of it. And that’s, I think, the most important time to turn inward and look at your thought processes. What are you speaking, what are you thinking, what are you believing, and those all affect your actions. Our words are powerful. If you want to think of it in a scientific way, sound waves are a physical thing. We all know that sound in the air has a physical attribute to it, right, it’s scientifically proven. So when you speak you are affecting your life. You’re either affecting it for good, or for evil, bottom line. I have patients come in who say, oh I have this and I have that and I’m never going to get better, by the time I’m this I’m going to be in a wheelchair, da-da-da-da. Or they come in and they go yeah, the doctor made me come but I don’t know why, nothing has helped, I’m not going to get any better and I’m just going to have to live like this. Until I change their mindset, I can’t help them. Because as long as they believe they’re not going to get better, they’re right. Okay. And I think a lot of people are out there – and this man who called me – I forgot to say he told me point blank he didn’t want to learn how to fix himself, he only wanted to be told what to do. He says I’m really good, I’ll do what you tell me, I’ll do all the homework, but I don’t have any interested in any of this, I don’t want to learn how to fix myself. I’m thinking to myself why would you not want to know how to fix yourself? That mindset, I don’t even know where to start, so.
Dr. Maya Novak:
And this is so extremely important. This is also my approach to injury recovery because you can do all the exercises, but if inside, if something’s preventing you, you don’t believe, you’re losing hope, you are not dealing with emotions, with feelings – you can do all the exercises but they are probably not going to help you. So thank you for sharing this. I know that we are running out of time, but I do have just a couple of questions. What is your number one advice to a person who is recovering from an injury?
Get the diet right, absolutely. If you do nothing else, get the diet right. That is going to affect you as long as you’re above ground and lengthen the time that you’re above ground, absolutely, and your quality of life. There’s nothing more important than diet. And I’m not perfect at all. I’m not perfect at all. I enjoy a glass of wine now and then. I’ll have something that’s not considered healthy now and thing. But 99% - well, I should say 90% of the time, I am eating very healthy. I enjoy my food, it tastes good. I’m not suffering by any means. I’m 60 years old. I don’t even have ibuprofen in my medicine chest. There’s no Tylenol. There’s nothing in my medicine chest. When my oldest daughter had to do a report at school, they had to see what was in the medicine chest – it was this thing to showcase safety and all this stuff – and I had to call her teacher and tell her she wasn’t lying that there was no medicine in our medicine chest! She didn’t believe her. So it’s huge. I mean I can work 12-14 hours a day and not feel tired. I do an online video training series. I recorded the back modules Sunday, and I literally exercised for three hours recording the video. The last video was 21 minutes and I did 240 lunges with my body going in all these different directions. I don’t know many people my age who can do that and be okay. So nutrition is huge.
Dr. Maya Novak:
But what about if a person – we talked about how you approach a person who has tried everything, but right now, I’m sure that there are people who are listening to this and they are losing hope. They don’t believe that things can actually get better. What would you say to someone who is losing hope?
I would say never ever, ever give up, at all because once you give up you’re done. That’s the only way to fail is to quit, right. The important thing is to – I think all of us innately have wonderful intuition. That’s a term everybody’s familiar with, intuition, wherever you believe that comes from. Intuition will tell you if somebody’s speaking the truth or not. Now, if it sounds like it’s too good to be true, it probably is. There’s a lot of stuff out there where people are just marketing their program, and I’m not saying that they’re not honest people, but they truly believe their program is the end-all be-all and it’s going to everything. I never make those promises. I tell people let’s start working and see how you respond, let’s figure out what’s going on and when we see how you’re responding we’ll know what direction to go. Okay. But I think, you know, don’t lose hope. The human body is absolutely mindboggling in its ability to heal and repair. We just need to provide what it needs.
Dr. Maya Novak:
Beautiful. Oh my goodness. I love you. I’m so grateful for your knowledge, for your expertise, and for sharing it. So one last question that is a bit more fun is if you were stuck on a desert island and you were injured and you could bring only one thing that would help you heal perfectly, what would that be?
So I thought – I knew this question was coming – and I thought long and hard about it – and I don’t even know if I really have a good answer. Obviously, I’d have my mind with me, and that isn’t something I’m bringing – well, I guess I am bringing it with me, right. So it’s probably the most important thing because I’m going to use all of my knowledge, my expertise, my experience, to work all the things that I know I can work that don’t even need any equipment at all. But if there was an item, some kind of a product that I wanted to bring with me, probably – I know how to do all the three-plane motion so I can recover my asymmetry and be symmetrical, that requires no equipment. But to address my neuro fascial system, it would require equipment and my favorite is the MELT method – the roller specifically, the soft long roller. It’s very, very soft – I could even – and I’m not trying to sell you anything – but I’ll show you the difference in how soft this is compared to what’s out there. It’s very small in diameter and I think it is the best way on the planet to address neuro fascial inefficiency. To hydrate and lengthen, decompress the body. It’s fabulous. If you can’t lie on the floor without pain, you can do 10 minutes on a roller and be on the floor without pain. I have vast numbers of the college start crying at doing a MELT class because they couldn’t believe they’d got rid of their pain, they’d had it so long, so it’s amazing.
Dr. Maya Novak:
Great. Eileen, I could be talking with you for hours! But we’re going to slowly finish here. Please share with us where people can find you, reach out to you who would love to work with you, please share where to go.
Well, I have a couple of websites. My main website is havelifelongwellbeing.com. The program that I’ve video recorded that will teach people how to move their body and the way to address specific areas of pain, but basically to address the whole body based on – so I’ve got a knee module that’s done, a shoulder module that’s done. I just completed the back module, and that should be up and available within the next few weeks on the website, and I have other ones coming. That is movewithnopain.com. Then my email is email@example.com. I do monitor my email closely because I work with consulting all over the world, and when they need me, I have to be there, so I’m constantly checking email. I do get back to people. Sometimes they’re very surprised at how quickly I can get back to them. But I love working with people. I love helping people. I have the best job in the world because I see people get rid of pain, and yeah, I’m a very blessed person.
Dr. Maya Novak:
Thank you so much. Thank you, Eileen, for being here, for sharing your knowledge and I’m extremely excited for everyone who’s going to reach out to you and get rid of this pain and address other areas, not just do the exercises.
Yes, and even if they don’t need to contact me – just knowing how important all the things are that we discussed. It will change their decision-making and end up giving them optimal outcomes, that’s it.
Dr. Maya Novak:
Thank you, Eileen, for being here.
Thank you. I very much appreciate it.
Dr. Maya Novak:
This wraps up today’s talk with Eileen Kopsaftis. If you haven’t done it yet, subscribe to the podcast on whatever platform you’re using to tune in. Of course, also remember to share this episode with your loved ones and help them out. To access show notes, links, and transcript of today’s talk go to mayanovak.com/podcast. To learn more about The Mindful Injury Recovery Method visit my website mayanovak.com and find my book Heal Beyond Expectations on Amazon. Until next time – keep evolving, blooming, and healing.