In episode 27 of The Real Talk, Raquel Ramirez welcomes Dr. Katie Dabrowski to discuss how we can improve our life and health span. They dive into topics such as nutrition, exercise, fitness, and debunking misinformation in the health industry.
Tune in to gain valuable insights and expert advice on maintaining a healthy lifestyle.
TIMESTAMPS
[00:02:24] Providing Holistic Healthcare Experiences.
[00:08:06] Understanding Pain.
[00:15:19] Risk and Growth.
[00:24:03] Back Pain Misinformation.
[00:27:05] Approach and Information in Rehab.
[00:39:32] Evolutionary Psychology and Biology.
[00:49:09] Mindset and Pain Perception.
[00:52:17] Dealing with Emotional and Physical Pain.
[01:00:14] Fortifying Relationships With Ourselves.
In this episode, Raquel Ramirez and Dr. Katie Dabrowski delve into the concept of pain and discomfort, shedding light on how our bodies respond to these sensations. They emphasize the significance of shifting our mindset and gaining a deeper understanding of the processes involved in experiencing pain.
Furthermore, Raquel and Dr. Katie stress that pain does not always signify harm. They argue that pain is an inherent part of life and does not necessarily indicate severe damage. They caution against the misconception that being pain-free equates to being healthy. Instead, they encourage embracing pain as a part of the human experience and understanding that we will go through ups and downs where pain is present.
QUOTES
SOCIAL MEDIA LINKS
Raquel Ramirez
Instagram: https://www.instagram.com/featured_properties_intl/
Facebook: https://www.facebook.com/featuredre
LinkedIn: https://www.linkedin.com/in/raquel-ramirez/
Dr. Katie Dabrowski
Instagram: https://www.instagram.com/ktdabrowski/
Facebook: https://www.facebook.com/OldBullAthleticsMiami/
WEBSITES:
The Real Talk: https://www.therealtalkpodcast.net/
Featured Properties International: https://msha.ke/featuredre
Old Bull Athletics: https://oldbullathletics.com/
Welcome to The Real Talk. I'm Raquel Ramirez, your host and real estate professional here to bring you insightful conversations, expert advice, and powerful stories about what really goes on in life, love, divorce, and real estate. Are you ready? Let's get real. Hello and welcome to The Real Talk, my friend. How are you doing today? I'm fantastic. I'm so happy to be here to chat with you. You are not happier than I am. I promise you that. I'm already giggles, which is great for the audience. I am talking today to the most important person that I can think of. You are just a saving grace in my life. This is Dr. Katie Dabrowski. So everybody, please, in your cars, wherever you are, just a little applause.
That's the best introduction I've ever received. So thank you for that.
Well, you know how I feel about you for the people who are listening. I mean, anybody who has actually spoken to me at some point or another, at least in the last, what, how long have we known each other? Like two years? So if somebody has come to talk to me in the last couple of years, they know something about you because I always have something to say. You know, we've been training now for two years and this is actually possibly going to be one of the most nerve-wracking podcast that I'm going to release and I'll tell you why. You know this, that this is like a very important topic for me. Health, nutrition, exercise, fitness, all of that is important to me. And I feel like I have so much I want to cover. It's going to be impossible. And I feel like people need to know. And there's so much misinformation and disinformation and TikTok this and someone who's supposedly an expert there. And it's just it's a horrible thing. And so I want to kind of unravel this and unpack as much as we can. So I guess before we get started, tell us a little bit about who you are. I said, doctor, obviously. So I want you to tell us a little bit more about your background so that people get acquainted with you and your expertise.
Yeah, absolutely. Oh, I'm excited, too, because this is the stuff that we get excited just talking about in our sessions. So yes, good. Yeah. So I'm a physical therapist and a strength coach. So I kind of wear two hats. And my main goal is to be able to provide people with the type of health care experience that goes beyond labeling somebody with a diagnosis labeling somebody with something that they think is in quotations wrong with them, giving them a lot of limitations and making people feel broken. And we can totally dive into that. But that's unfortunately a big part of the health care system now is we kind of get a label slapped on us and then we think that there's something wrong with us forever or the amount people who come in to me and say, I just have bad knees and I've had them forever. Or there's back pain in my family. I'm screwed. This is what it is. And a big mission of mine is to just completely wipe out that narrative and help people realize how much more resilient we are. So I get the pleasure of doing that at a facility called Old Bull Athletics. We are located in Coral Gables and in Pinecrest. We have two locations. We're a completely individualized, one-on-one, one-stop shop for everything you need on that spectrum of injury rehab to performance and strength training. So we don't really believe that there's a difference between training and rehab. There's an excellent quote out there, rehab is just training in the presence of injury. So it's all about being able to appropriately challenge somebody, no matter what they're dealing with, to make changes, make adaptation and get better and realize people can do so much more than they ever thought possible. So I'm really lucky to get to be a part of a team where we get to do that every day. We have so much fun. Raquel, you know, you and I work together, but you can see that the environment is it's a complete family at Old Bull. So great. We're all really passionate about basically giving people an experience with health care that they didn't even know existed.
Yes. And thank you. Thank you for that. Because I always felt like I was in search of that. And I came to you, you know, through another doctor, different kind of doctor. But I came to you in search of something that I knew had to exist and yet I couldn't find it. Right. I know that when I first came to you, I had lower back pain that I couldn't get rid of. And truth be told, I had that since I turned 30. And that's a really important point because when I turned 30, I know it sounds funny, you know, I had like a midlife crisis. There were a lot of different reasons why I came to that point in my life, not because necessarily I turned 30, but it just so happens that it did. And I started with this nagging lower back pain and I couldn't figure out what it was. And of course, I had been an athlete in high school, in college, and I always worked out. So I thought I, you know, I wasn't necessarily overweight, you know, a couple pounds here and there, but nothing that should have put an enormous amount of stress on my back. I also hadn't had an accident of any kind. So where did this come from? And You know, I would talk to this guy and I don't know, like that trainer and this guy who supposedly knew a little bit more about this. And I did some research and everybody always had a quote unquote quick fix for something that just really wasn't going away. And so fast forward almost almost 10 years, because if I'm going to be 41 now and this was two years ago, yeah, I met you, I think, January, February of 2022. Yep. Yep. So fast forward almost 10 years and that was coming and going. It was really getting in the way of me playing beach volleyball in my 30s. And to a point where people would tell me, my friends would tell me, you need to stop playing or you're going to really injure yourself. And I was like, Oh, push through it, you know, and, and I did. And there were some days where I was miserable. And I remember, I don't know if I ever told you this, I would lie down in my apartment and instead of sleeping on my bed, which was by the way, a Tempur-Pedic worst thing I had ever purchased. But, um, I lie, I would lie down on the floor and sleep, you know, with like my legs at a 90 degree angle, like on a chair or on the bed to get some relief. That's no way to live. And if you ask anybody, well, you know, maybe you just, you know, you, you herniated a disc or, uh, my favorite was the, um, I don't know if he was like a spinal doctor. I don't remember what it was, but he was like, listen, you know, you're going to have to lay off the sports because all this is doing is, you know, wearing and tearing at your lower back. You're eventually not going to be able to move. And of course you're 33, 35, 36. And you're like, what? That cannot be.
Oh my gosh, you've just touched on so many. Yeah, like you, the everything that you just described with your story is basically the type of scenarios that we're used to hearing people come in with where unfortunately they've had a pain experience that's been so poorly managed that they now think they're broken and they're just too in quotations old to do anything about it. Right. There's a lot of things you touched on that I kind of want to break down a little bit. Go for it. The first and foremost thing of just that, like with back pain especially, so we're going to focus on that, but this could be extrapolated to kind of any musculoskeletal pain. Like when pain doesn't really come on with any notable cause or a mechanism of injury, like what we say, you said you didn't have an accident, you didn't have a fall, you didn't get hit by a truck, you didn't have something happen that would like logically explain why you would have pain. That tells us something about our really gross misunderstanding of what pain is. In the medical community for a very long time, our explanation of pain was the biomedical model. It was basically like a logic equation. If this, then this. If I touch this sharp thing, then I will feel pain. It was this very linear mechanical explanation for pain. However, what you just described is not at all a mechanical explanation of pain. There was no cause. There was nothing sharp that you touched to give your brain the information that you should experience pain. So this already shows us how, as a medical community, we have a pretty poor understanding of what pain is in the first place, and people can experience pain without a known mechanical cause. So with that we really have to kind of create a different understanding of what the pain experience is and I always say that I say the pain experience because pain is so subjective it is an experience it is important but it's not always the sign of tissue damage what I always tell people. It's kind of one of my statements that I find myself saying all the time. In the absence of a mechanism of injury, an extreme trauma, or extreme red flags, most pain is because we are exposing our body to something that we haven't exposed it to in a long time and we did a little bit too much too soon, or we're doing something that exceeds the demands of what our body can currently do. That's what getting older is. We stopped running, we stopped jumping, we stopped doing all of these things where we're super active. And then we try again at like 35 and it hurts and we're like, Oh God, I knew it. It's all downhill. Everybody said that it all sucks now. And we're very quick to make that jump because also the physician we just saw said, yeah, you shouldn't be playing sports anymore. Yeah. The explanation really needs to shift to, Oh, you haven't done that in a while. You just jumped right into it again. Let's create a plan to make sure your body is ready for the demands that you want to place upon it. Then you're going to be able to tolerate it. That's the conversation we should be having. And that's what we focus on. We do a lot of that together. We do stuff in the gym to make sure you can do the crazy stuff that you want to do when you play volleyball. Like that's what it's all about.
Exactly, exactly. And so the people that are listening understand it. If I haven't told this story to somebody before, I actually came to see you and, you know, we, we assessed the situation. We got to work and my pain subsided within two weeks and I haven't had pain ever again. And I've, in fact, I had stopped playing volleyball. Um, I don't know. 30, I don't remember how old I was, 36 for, you know, different reasons. And yeah, I think it was around 36, 35, 36 anyway. It had been like five or six years that I hadn't played. And I remember thinking, I want to get back to that. I would really, really love to get back to that. And at this point, when I came to see you, you know, I had the lower back pain. I wasn't as athletic. I didn't feel certainly I didn't feel as athletic as I, as I have in the past, you know, had let some of those things go because I couldn't find the right answer. I couldn't find the right mobility exercises, let's say to strengthen the areas that I was weakened at the time. And so working with you, number one, I got rid of my back pain almost immediately, which was. It was unbelievable after so many years of trying this and listening to that doctor and this Cairo and whatever. And then fast forward several months, you know, I remember telling people I was in the greatest shape of my life. Now, some people know that I competed in bodybuilding, you know, I would think it was like 34, 35 years old and yes, I looked good. Um, but I didn't, it wasn't necessarily my strongest. Absolutely not. I looked good. And yes, I, you know, had a shred, a lot of, you know, body fat and all that kind of thing, but I wasn't my strongest or my most agile. I felt good, obviously, but even though, you know, I got down, you know, some pounds and I leaned out a little bit, you know, when I was working with you in the first year, I was the strongest I had ever been. You know, I started to do all these pushups that I didn't really think I could do before. And then of course, let's not forget no back pain. And, you know, really started working on my core and understanding what my core included. Let's say included, right? Because most people think core, they're like, oh, the ab section. It's not just your ab section as you can, you know, tell us. And yeah, so I hadn't felt that strong And then fast forward a few months after that, and I started playing volleyball and I got right into it. Yeah. And I've had a couple of injuries, you know, not because of not having, you know, the strength or whatever. Those were stupid injuries, like falling into a crab hole at Kennedy Park. Right. And Miami's awesome. Yeah. almost destroying my ankle altogether. Um, and I was able to rehab that with you also at record speed, because now we understood, like you said, what pain means, um, what it tells us about the body function, whether something is severely damaged or not, um, and how to address that. So you can expect quicker recovery.
Absolutely. And I think what, you know, what a lot of people don't realize is that, you know, all pain doesn't equal harm. And what we try to do and what you and I have worked on a lot together too, is also like this understanding that pain is part of life. And I think we conflate the idea of pain free equals healthy, right? I am only healthy if I never experienced pain again, instead of again, almost embracing as part of the human experience, the understanding that no matter what, we're going to go through ebbs and flows of life where we're going to experience pain. At some point, it's going to happen. What we want to work on with people is how can I make you so strong and resilient that even if something does happen, you're going to just be better set up to handle it and tolerate it. I can't prevent injury. Nobody can prevent injury from happening. I can't prevent you from falling into a hole. But we can make you so strong and resilient that you can have a way better time handling it because your body is prepared for the demands that you're placing upon it. And that's what I think it is. It's just being open with the fact that we're not gurus. We're not going to fix you. We're going to make you so strong, though, that you can handle any situation that life throws at you. And I think that's what everybody wants. That's what I get excited for with getting older. I become more excited with the idea of, like, how can I keep feeling as good as possible for as long as possible? How can I keep treating my body as well as I can? And how can I be so resilient that these aches and pains that everybody told me as soon as I turned 30 were going to become my reality, it's all downhill from here. How can I be so strong that I barely notice them? Like that's what I want.
That's such a psychological, just, you know, I was thinking about something now, as you were saying that, that you can't experience life without pain. And that is true across the board, because whenever you are going to grow, whether that's spiritually, emotionally, financially, I mean, you have to risk certain things. And sometimes that risk of saying, pushing your comfort zone, for instance, that usually causes some form of pain. I mean, it's not excruciating necessarily, but it does create some form of pain. We just, we label, I think, the pain that you're talking about, as you mentioned earlier, as something that we should run away from. And then the further you get away from that pain, then the less you're moving and you know, the less you move, the more you set yourself up for failure, basically.
100 percent. You bring up a point that I try to explain to people all of the time, and it's kind of the the vicious cycle of pain. So let's think about this from the perspective that I think everybody can relate to. And also, everybody has been told is dangerous or bad. So deadlifting. Everybody ever comes in and tells me I have back pain. My doctor told me to never deadlift. It's terrible. Or I can't, I can't pick up more than 20 pounds. And so my doctor told me, um, you know, all of these things that challenge accepted. Exactly. Most people have been told. So if we reframe how we can potentially think about why deadlifting might hurt instead of it just being inherently dangerous, which Thanks to wonderful rehab science literature and evidence, we know that it is not inherently dangerous and that no exercise is. It's just if you're underprepared to perform it. If we're scared of deadlifting and we're told that it's going to make us hurt, we're probably like never going to deadlift. And we're going to also curb and self-select, even without realizing it, other exercises that are the least similar to deadlifting. We're going to prioritize every movement pattern that doesn't look like it. And then you're going to be put in a position in life where you have to do something that looks like deadlifting. You have to pick your kid up off of the floor. You have to pick something heavy from the grocery store up off the floor. Or maybe you started working out and you do start deadlifting, but you're kind of nervous about it because you know it's like evil. We can experience pain simply because we are so deconditioned to the position and haven't built up the tolerance to it that you can experience pain when you try it again and then all that's doing is this self fulfilling prophecy of like see. I knew it back. I can't do this. So I urge people to like shift that. Okay. This position, if we can build into it, so it's not like a surprise movement, your body's not used to, let's see how better you tolerate that over time.
Yeah. And you said something that got me thinking about, um, even though I kept moving, right. I noticed that my body, you know, for sake of saving itself from experiencing that sort of pain, I started to default to muscles that I probably shouldn't have been using. And so I started to notice that my hips, I don't know if you remember that my hips would kind of, um, what's the word, I guess, shift maybe when I was going to do a certain movement and we knew that we needed to strengthen, you know, certain muscles in those areas in order to get my form back to where it was, which could eventually lead to further injury. And that's what people think they do that. And then they're like, well, you see clearly something is wrong with me and I shouldn't, you know, do X, Y, Z, you know, like dead lifts. Right.
Yeah. And what I always say with that too, is, you know, the brain does a really good job of protecting us. And it also does a really good job of making sure that our body can do what it needs to do, even if we're lacking certain things, most efficient way possible. So we have back pain. Our body's going to figure out a way to kind of circumnavigate it and use other postures, use other positions that are maybe compensatory. Um, and I don't like to say compensatory in a negative way either, because that's a good thing. If you have an injury and you still need to like get up and go to work. Your brain is very good at making sure you can do that. It just might not be the most optimal way for whatever your goal is. So compensations aren't always a bad thing because like you're still able to do most things. It's more of like, okay, how can we create a strategy where you're using maybe muscles that are bigger and stronger to help this movement instead of relying on like the little guys that are kind of taken over right now. Or how do we match this activity back to your goal a little bit more? If you have a goal to play beach volleyball, it would probably be important that we can do that in a way where you use your hips more than your low back muscles. So it's all about like, how do we find what's best for the goal? And that, you know, compensation isn't necessarily a bad thing. It's just, there's probably a strategy that's going to be better for you.
Right. All of this reminds me of a good friend that I have that I introduced you to, whose life you also saved. I won't, you know, I won't say who it is, but he used to play beach volleyball. Actually, that's how I met him. I met him playing beach volleyball many years ago. And this is a fit guy. I mean, fit guy, washboard abs. So you would think this guy has absolutely no issues with his body. And he's, I believe also in his forties now. And I came to find out one day we had met, he's like, I got to go. I got to go to the chiropractor because I'm supposed to be put in traction. I'm like, wait, what? What? I used to say that as a punchline to a joke. I didn't know people actually did that. You're going for traction. Why on earth? And so whatever, we got into this conversation. I said, no, no, no, no, no, no, wait, wait, wait. He said, yeah. And the doctor told me I might need to get surgery. I haven't done this and that haven't played volleyball. He had mentioned like all these things that he wasn't able to do anymore because he was just miserable of how much pain he had. And then doctors giving him all this advice. And I said, please, please, please, please. Before you continue, you need to hear me out. So I gave him the spiel, right? I gave him the pitch because I'm so happy.
Brand ambassador position at Old Black.
So here you are on a silver platter, right? Cause I'm, I'm introducing you as the greatest things in sliced bread. And I explained, you know, what, what kind of benefits I had received and whatever. I went through the whole thing and he was pretty intrigued. He's like, at this point I will try anything. I'm like, perfect. So I sent him your way and well, you tell me how that resulted in.
Yeah. And as always, you know, we appreciate your reviews. So and I he was so wonderful to work with. And he was a an unfortunate, great example of everything that we just talked about. You know, this is an incredibly fit and athletic person. Yes. Set records for paddleboarding distances, hikes, trail runs, like one of the most amazing like adventure athletes. super active, um, and was basically given information that made him believe that he was so fragile that he could never do these things again. Um, and so a lot of our beginning sessions were more of just kind of unpacking a lot of the misinformation he was given. And this is a tough thing, right? Because I never want to make somebody feel dumb for the information they've been given. And I also never want to make I don't want to position myself or our facility as, you know, we're bullying anybody else who is giving information that we don't agree with. So that's always the tough part, because I don't want to be in that position. So a lot of it was more just conversations of, you know, in the absence of really severe red flags with the low back. And these things are very severe and very obvious, like the inability to go to the bathroom, or the ability to stop yourself from going to the bathroom and like loss of movement in your legs. Those are three super severe and serious things. In the absence of those three things, all of the literature that talks to us about what the heck to do when people are injured with their low back tells us that most low back pain is not at all severe. It doesn't mean it doesn't suck. It doesn't mean it doesn't hurt, but it's not a structural thing that we have to be scared about. So if you don't have those problems, changes in your bowel and bladder function and changes in your ability to move your legs, like very severely. If you don't have that stuff, you should never be told that you have back pain that you have to be concerned about. That's part of the disconnect is people are getting so much misinformation that as soon as they feel back pain, they're given medication and they're told they need surgery or they're getting an MRI immediately. You are not supposed to get an MRI unless you have those symptoms present. Interesting. How many people you know with just a bout of back pain who their first course of action is they're receiving an MRI. It's not the patient's fault. They don't know that. Of course not. The provider should be providing appropriate medical care.
Well, there's insurance and all that too.
Correct. That could be like a three hour special. So a lot of it was just helping him to kind of understand, like, I am not at all saying that you don't have pain. I am saying there's ways that we can work through it because you don't have any of the symptoms that show me that you have a severe disability that we need to be concerned about. And that time it was not, I'm good at my job, but I'm not that good. It wasn't after the first session that he even believed me. No time. And I basically just started peppering in some entry points for the most difficult movements that he had. So dead lifting was a big thing. And this guy loves to lift. Like he's incredibly fit. He wants to be perfect. And we were having a lot of these conversations and then rebuilding his deadlift, having a lot of these conversations, rebuilding his squat, having a lot of these conversations, rebuilding any other movements he wanted to be able to do, and also giving him the green light. Okay, why don't you go out and paddle for 30 minutes tomorrow? And he was like, really? Yeah. Like surprised that I would even say it's OK to do the thing that he came in to want to getting back to trying to kill me. Yeah. And it was basically these constant mindset shifts and aha moments of like, oh, I'm OK. I'm okay. Or I feel some tension in my back. I have muscles there. That's okay. A lot of times I'll just show people truly the anatomy of the muscles of the back and say, yeah, you have a ton of layers of muscle here. When you feel back pain, it's not your spine, it's all of these back muscles. It's the same sensation of when you're doing a biceps curl and you're stressing your biceps and you feel it, but we're weirdly okay with that. We're not okay with feeling like a sick low back pump. So I'm just trying to reframe that. And he actually just reached out to me in the new year and he was like, Hey, just want to let you know, I just paddled for like four hours. Thanks for everything. Like he's doing. terrible. By all means, go and paddle for hours. That's all you. But that's awesome.
I actually haven't checked in with him, but I'm really happy to hear that. Really happy to hear that. See, that's it. That's a perfect, that's a perfect example of misinformation gone extra wrong, right? Because he could have easily given up and gone and continued to have traction, however that works, and maybe even have surgery. And then he would have been in probably a far worse position. I don't really know how that works. I'm not a surgeon. I'm not whatever. Um, but that's a great example of, of how having the right information and approaching this in the right way could get you to basically rehab. That's really, you know, and you said something that I'm, it keeps coming back to mind. So I need to mention it. It's, and it's, it's funny because I don't consider myself a genius, but I consider myself a pretty smart individual. And still, there are some things that I catch myself thinking. I'm like, what did I really believe that? Did I really just say that to Katie? Did I really just say that? Like, I used to be worried that if I misstepped, like let's say coming off the sidewalk or something, that my hips would like misalign or, and you remember you told me, you're like, you know, we're really not that fragile. we'd be screwed.
Nobody would be able to walk. And that's another thing that, you know, in our industry, we'll get some pushback with because in a PT school, we're basically taught to do all of these tests and do things with our hands to like put people back into alignment. For anybody who's just listening, I'm using a lot of air quotes. And we're first of all taught that we can even distinguish movement in a joint, like, which is crazy to think about now that we ever really thought that we could do that. And we're also taught that, like, our hands can produce enough force to make a change to a bone or a connective tissue and really dense and tough stuff. Interesting. The amount of force that you would need to actually move somebody's bone would be, like, a truck hitting them or... Or John Wick. Correct. And it would be super dangerous. Like, if it's that easy for me to put your hip back in place, doesn't it mean it's that easy for me to take it out again? It's crazy. Why is it only one-sided? And this is where there's a lot of division in our industry. You have people who are very, very focused on a lot of manual therapy techniques. And I'm not at all saying they're bad or wrong. But then the other side of it is this realization of like, am I actually moving this person's bone? And if I could, doesn't that mean that we are all pretty fragile and at any scene might dislodge your spine? Like that's easy to think about. So I think there's also this, like the amount of people who come in and say, yeah, the last person I saw every time before we started our session, she had to put my hip back in place. It was like, Oh, what happened? Yeah. And just knowing and helping people learn, like, you know, we're not, Putting bones back in place we're not readjusting you can't come in and out of alignment that way unless you had some sort of joint instability or trauma happen. So much more of what people need is to just find an entry point for movement and activity and for building. and be consistent and building and make sure what they're doing aligns with their ultimate goal. That's really what we need. The problem is, is that's not really sexy and it doesn't sell as well as like, I can put you in a session and I can put your hip back in place.
Yes, of course. I have learned so much from our sessions and I love it. I love asking. I love getting to know a little bit more about the body and how certain things function. One of the things that I think has served me well is to know now That pain isn't always an indicator that like you said, that something is wrong or something is broken. And I'm also using air quotes here, um, you know, because we have discovered, you know, some, some minor injuries or, or things that maybe I've, I've kind of not known that was lying under the surface. Um, and you know, when I come to you or I've been, you know, maybe I overdid it at volleyball one day or whatever the case, you know, I'm like, Hey, I'm a little sore here, whatever. And I know that when we get into that position, you know, and once you start using that muscle or that arm or that leg or whatever, you start to realize that that pain actually subsides as opposed to getting worse. And so I know that when we assess the situation, you know, keeping, um, mind of that, you know, paying attention to whether the pain worsens or, you know, like when I, I, I sprained my ankle, you know, if I could stand on it, you know, if that was an indication of maybe there was like a big, you know, break or a tear or a fracture, um, you know, so it's, It's about that. It's exactly what you said. It's about learning more about the body, having the right information in hand and working with people like you, you know, doctors who really understand the body and can tell you physiologically, you know, what you should be doing to live a full life. I can't imagine being sedentary for the rest of my life. Might as well die now.
Right. Absolutely. And you know, there it's interesting because what I try to help people think of is like pain's a data point. It just gives us information. It tells us something. It doesn't necessarily mean stop. If I have pain, when I start to increase the weight in my squat and my knee starts bothering me, I don't have a knee injury. I don't have a knee problem. I have a strength issue. I gotta get my strength up so I can better distribute the force of this new demand that I've put on my body that maybe I'm not ready for yet. So maybe I need to decrease the weight. Or maybe I keep it just as heavy, but I squat to a box instead. Or maybe I lower the weight and I go slower and I pay attention to that point where it feels really tough and I pause there. It's all about how can we use pain as a data point, as a metric, instead of thinking, oh, if I have pain, I need to stop. The analogy I often use too, If there was something wrong with your car, like it just didn't turn on, and you kept it in your garage for three weeks, and then you went in and expected it to start running when you turned it on again. I mean, does that ever happen? Absolutely not. So similarly with pain. If you have pain with a movement and you're like, well, I'm just going to lay off, and then you try again in a couple of weeks, of course, it's still going to hurt. Nothing, nothing. And your body got, if anything, actually even less used to the movement. So it might even hurt more. So it's all about like, how can we just use pain as information and be a little bit less scared of it and understand that it's just something that's telling our body that maybe we need to change what we're doing, modify or get more prepared for what we're doing.
Yeah, yeah. I know you and I have talked a little bit about some of the books that I was reading. The one by, I think it's Dr. Peter Attia. I think that's how you say his last name. I remember we were, the book is about, oh my God, what's the name of the book? I just drew a blank. Outlive. Outlive, yes, exactly. Thank you. He talks about the four deadly horsemen, and I'm not gonna get into what the book is about, but I love the chapter, and I don't know if it's a chapter, I don't know, it's somewhere in the middle of the book, when he talks about exercise, and he literally says, that of any and every medication under the sun, exercise is by far the most effective. Yes. Of any medication anyone could take for any known reason. Yeah. I mean, and I highlighted it. I was so happy when I was reading it because of course, at this point, I'm totally into this. I mean, I've always bought into exercise. I understand the health benefits, I think far more than your average person. And I enjoy it. I love being able to move my body. And I love that I still play volleyball. I would love to keep playing for 30 years, you know, I want to be a centenarian at this point. I mean, and for anybody else who's listening, if I haven't already told you, my preferred beach volleyball partner is a 60 year old guy, you know, and he plays better than some of these 20 year olds. You know what I'm saying? He is out there killing it. He's got, you know, like a six pack on him. He's just he refuses to give in to this stigma, you know, and this idea that age, you know, is is is downhill, you know, after a certain point. Right. But yeah, to the point of exercise, he, for example, is a great, you know, case in point that he maintains active. He stays active. He refuses to give up. He wants to move. He also believes in forward motion, meaning that if something hurts or he's not feeling too well, he probably should go out for a walk as opposed to just sitting it out. And that has worked really well for him. And I can absolutely agree with that because I do it, too.
Yeah, yeah, 100%. I mean, yeah, there's like, I could go down a rabbit hole. And this is not even my, you know, there's people who are more well versed in this in the research side of things, but just the amount of downstream effects that are exceptional for what exercise does, what we're getting chemically happening, what we're getting, even with like, you know, precursors for how we process sugar, and all like, you can imagine is positively impacted by exercise. And On top of that, the thing I often tell a lot of my patients as well is having muscle mass is basically like the cheat code to life. Muscle mass and testosterone and the properties that are involved in building muscle, maintaining muscle, all of these things have protective effects over life stressors and the actual chemical representation of stressors, hormones like cortisol. When you have more muscle mass, you're better able to tolerate the negative effects that would otherwise occur with the stress hormone response of cortisol. What I mean by that is, so cortisol is catabolic, meaning it's a type of chemical that its job or one of the downstream effects of cortisol is that it will break down muscle. That's a catabolic effect of cortisol. However, when you have more muscle mass and more testosterone, this is men and women that decreases the catabolic effects of cortisol, meaning you literally can handle stressors better and you can handle stress hormones better if you have more muscle, right? That's insane evidence for me to say every single person ever in the world is just trying to train some way. The more muscle you have, the longer you've been exposing your body to resistance activities, the better set up you are for success.
It's just, it's true. It's true. It's a hundred percent true. And I feel like something about that was in that, in one of the chapters in that book, that book is actually a little more difficult to read because there's a lot of medical terminology that, you know, you could get lost in. I mean, not all those things sound the same to me. There are all these codes and things that I'm like, I thought we talked about that code in chapter one, but clearly this is a different one. So it's a little, you know, it could get a little confusing, but the gist of it is there. And, you know, I love that, that chapter about exercise and how exercise affects all these other hormones. And let's, let's even move past that. Let's talk about the psychological and mental emotional effects that exercise has for people who are feeling let's say depressed or stressed. It could be frustration. It could be, you got into a fight with your spouse. You know what, go walk it off, but you know, maybe go for a run or go for an exercise. I know. And I can say this from personal experience that it freaking helps. It does. I could be in the worst mood. And if I managed to get myself into a good workout, I literally forget about it. I can't even force myself into a bad mood anymore because everything with my body is going in the right direction. It's flowing and I'm getting the right oxygen. I'm getting circulation going. I'm getting all the right pumps in all the right places. Not just, you know what I mean, that, you know, literally and metaphorically. you know, and it, you could just see it. You could, I don't have to put myself through a test, you know, or a machine to determine that exercise is good even for my mental health.
Absolutely. And, you know, where there's been at this point, so just countless studies on the impact of an exercise program, when you compare two people taking, you know, SSRIs for depression, and the comparison is jarring, people have exponentially better outcomes with an exercise protocol than using a medication or the same effect. So why would you not choose something that doesn't give you bad side effects if you could? And of course, this is not to say that medication is bad. There's absolutely instances when we do need it, but I'm, you know, we're in the business of behavior change. Let's see what behaviors change before we potentially need an expensive biological intervention. Um, it's also, you know, what I try to talk with people about too, and this is a little bit on the nerdier side diving into even just like evolutionary psychology and biology. Our reward system in our brain exists to reward humans for behaviors that bring us success or that are related to things that we've always had to do to be a successful species. Movement is one of those things. Being outside in nature is one of those things. So it's no wonder that when you're moving and when you're in nature, you feel better. You feel good. One of the most like human things that we can possibly do because of what we've been doing forever. So of course, our brain is going to reward us for that by making us feel better, making all of these chemical processes occur that give us great moods, get us feeling better, better outcomes, all of these things. So, you know, if you want to have a long life where you're feeling amazing, like go back to your roots of being a human being and do the things that make you feel good and make you feel human. That's absolutely moving your body and getting outside.
I love that. I love that. I do. I love that. And I, the opposite is true. Like for example, on days where, you know, I'm sick, let's say, you know, I catch a cold and I'm down for the count for like two days, like I was a couple of months ago, two, three days of lying down and my body is so achy. It's screaming at me. Like, what are we doing here? Can we do something other than just lounge around? And I can tell, and I'm an active person, you know, I play, I work out, um, you know, and I go through bouts, you know, like anybody, there are days where I'm like seven days a week and be careful if I don't throw an extra workout in, you know, to do like eight days that week or eight times that week. But. And then there are other times where I can only get around two or three times or four times a week. I think that's pretty normal. But for the most part, I'm a very active person. And the minute that I'm down for two or three days, my body is screaming at me to the point where I'm like, oh my God, I don't want to get back pain again. And you start freaking out, right? Because you're like, oh my God, I don't want to fall into that. But all it really is, is your body telling you, hey, listen, we need to stretch. We need to move. We need to get some blood circulating here. We need to get back to normal.
Absolutely. It's why one of the biggest disservices ever was that at one point we thought bed rest was what you were supposed to do to back hurt. And all it's doing is perpetuating the cycle. And you know, same with me when I do have those days where I'm a little bit more just like chilling out, which we all need. Yeah. on the couch, those are the days that my body is achy and feels the worst. And it's because we've created such habits that your body knows to crave movement, which is a good thing. It just tells you and it speaks volumes like we should be giving it that. We should be nurturing our bodies with contraction and blood flow and movement. And the idea of not using something if it bothers you, once of course, you've ruled out anything dangerous with a medical provider, It goes against everything that a human would normally do. And it's, you know, part of the, you know, society and our lack of understanding of health and wellness and movement, unfortunately.
Yeah. Now I thought I would touch on something that's a little less direct, right? And we're talking about exercise and, and movement and when you have back pain and things like that, but I've also personally experienced, and I like to use personal examples because I don't want to make assumptions of things that may or may not exist. You know, I can speak for something that happened to me and, you know, and I've had certain things happen to me. Like for example, when I went on vacation, not so long ago, where I had like that bout of sciatica or whatever that was. And I thought to myself, this cannot be happening to me. And of course, you know, I try to be as aware as I can about my body and the things that I do and what I introduce, you know, to, you know, say my body or like if I'm eating something different, you know, and I know that you and I had talked about that because immediately I called it. I'm like, I'm dying. I'm dying, doctor. You need to help me. Yes, this is the end. It was a horrible pain.
It's fine. You had that pain experience. It's okay.
But of course I'm like, I need to be pain-free. Because even still, right? Listen, we're all looking to be pain-free. Let's be honest. Nobody enjoys pain. You know, there's only those hurt so good moments, you know, but they're generally good more than they are bad. Nobody likes to be in pain. And I'm certainly one of those people. And just to kind of bring this full circle, you know, I was traveling. Of course I had, you know, airplane rides. You know, I introduced a ton of crap into my diet, which was something that I was not used to. Certainly not at the time. Um, and there were a couple of other factors, which, you know, they are worth and still, and also not worth mentioning, but my routine had changed drastically. Right. And so I was trying to figure out what it was that I was doing that was causing that again, no injury. Um, you know, I didn't sleep in a terrible position. Um, you know, I obviously wasn't playing a sport while I was on vacation, but there was a lot of sitting down. there was a lot of fried foods and things I probably shouldn't be eating or drinking. And I can't remember specifically now some of the other things, but I remember reaching out to you. I ended up having to get a heating pad and everything. And then of course you and I worked through that. And it's incredible how certain stretches, I mean, and I had him on both legs. I mean, from my lower back all the way down to my ankles and it was horrible. And you introduced me to the stretches. You told me about what to expect. You told me about what to look for. You know, you asked me a ton of questions. We went through the assessment process and I got over that in no time. And I think it wasn't so long ago. I think something like that, was kind of peaking, you know, it's ugly head. And I thought about immediately what we had talked about. I introduced those exercises and I didn't even come close to having any of the same symptoms. But again, to your point and everything that we've talked about, there are ways to go around that. And some people would, Oh my God, I've got to go to the doctor to get an injection, you know, because I've got sciatic. I can never move ever again because I'm at that point.
Right. Yeah. And I think what you've touched on really well is, again, like this really big misunderstanding we have with a pain experience and how many pain is so multifactorial. There's a slide whenever I'm giving a lecture, I talk about pain all the time. And I kind of show the comparison of that initial biomedical model I mentioned, basically, it's like the old school drawing of a man touching fire, and then signal being sent to the brain of like, ow, hold that. And it's like, it's a reflex arc. It's so simple. It's literally automatic. That's what we thought pain was. And a lot of people still think pain is compared to another slide where you see just the slide is almost covered with everything in the background that contributes to pain, your expectations of pain. Oh, deadlifting is bad for me. I'm already thinking about pain. I'm probably more likely to experience pain. Um, life stressors, any stressor, what a lot of people don't realize Your brain perceives any stress as the same cascade of chemical events, no matter what it is. Your brain takes any input as a stressor, good or bad, huge volume of stress versus small, like, you know, evolutionarily speaking, getting chased by a tiger versus sitting in traffic in Miami, all of those things are perceived. And like your brain is going through the same cascade of chemical and hormone events to tell, okay, your body to do like, send out the alarm bells, do all of these things because there's something dangerous happening. When you have a bunch of those inputs from a lot of different things, your body is in a position to be more sensitive to pain, to have more muscular tension because of the, in the anticipation of pain. Think of when you're scared, you immediately are in this posture where everything's tight and you're like walking through a haunted house and you're like this the whole time. You are creating more muscular tension and getting stiffer just because you are in a fearful or perceived threatening situation. Your breathing rate is going to change to short, shallow breaths, which of course, perpetually adds to the panic your brain already thinks you're experiencing. Because if you take these really shallow breaths, your brain's like, oh my god, something is wrong. Instead of being like calm and really just beautiful breaths. your heart rate increases, your blood pressure increases. These are all physiological effects that happen when we have any stressor introduced to us. So you're adding these things in. And so many people come in. They're like, I don't know what happened. Nothing changed. And then we dive into what just happened over the last two weeks when they started experiencing pain. And they're like, well, I broke up with my boyfriend. I didn't get accepted into the school that I wanted to. I had to move out of my apartment. I had a really big fight with my best friend. Like they're finding out all of these things where it's like, Yeah, you had a million stressors at once and you can kind of think of it as like the perfect storm scenario for your body to be hyper aware of pain and be in a position to experience more discomfort. And that's a mindset shift that a lot of people have a hard time with. But once you have it, it's hard to see more of like, We're humans and brains, we're just inputs and outputs. Our body is going through biological processes to respond to those automatically, but also we have to go through emotional and social and psychological processes as well, and that applies to every experience that we have. So it's a lot more than touching fire and feeling pain.
Yeah, that's I mean, as you were talking, I feel like I was trying to make sense of that. And then you came back time and time again to perfectly explain that. And because I was going to add to that, which is, yes, you know, you start getting all these inputs and then it's our job to determine, OK, this is just traffic versus this is a tiger. You know, maybe you are in the Serengeti and you're dealing with someone else's, you know, better have a fear. Right. You are right. You are required to tell your brain now, by the way, this is a legitimate threat. Not the guy in the back who, you know, you know, is honking at me for, you know, cutting him off or whatever the case may be. So yeah, it's about mindset. It's about learning then what to do with that information, because if what you have learned, or let's say your behavior is that once you experience pain, that's a red flag, I need to stop doing this, then Yeah, you're just going to create this habit on and on and on. And you're never going to get out of that vicious cycle. And you're not going to do something favorable to improve that situation.
rooting it in your physiology. So if you continue to be fearful and have what we call like fear avoided behavior, your brain, so the brain's job, it's basically a prediction machine. That's how we stay alive as humans. So our brain is constantly assessing information it's getting from the outside world and from our own tissues, sending information back to it. And it's processing and almost like quantifying threat. and seeing, OK, are we safe? Are we cool? Are we in a stasis? What do we need to do here? Yeah. And there's actual evidence of people with chronic pain where their predictive processing ability is impaired because they have such an expectation of pain that their brain starts to predict threat for non-threatening things, like bending over to tie your shoes, things that are not dangerous, should not really cause pain, but we are so we're conditioning our brains to expect it and that's a huge issue with pain and with chronic pain but it starts to make sense why little things that on paper should not cause pain do cause pain that comes back to again this awareness that not all pain is structural a lot of it is this soup of psychology, sociology, biology, all of the above. And again, it's not saying that pain is in your head, but your head's a really big part of it. And it's telling your body what to do with every experience.
That's actually a great segue into something I wanted to mention at some point in this conversation, because I'm sure people are wondering why on earth, if this is a podcast about real estate and divorce, we'd be talking about fitness and health. And well, there's a really good point to that. And I'll start off by saying, I believe that my lower back pain started when I became very confused about where I was in my romantic life. Okay. I was experiencing a lot of confusion, a lot of guilt, a lot of anxiety, things that I really wasn't sure how to deal with, you know, I this was in the wake of my mom's passing. I felt alone at times. I had a lot to deal with. And out of nowhere, this lower back pain started to show. And I couldn't make sense of it again because I didn't have an accident. I wasn't playing a sport. And that's particularly a moment. So I can't say, you know, I probably hurt myself, injured myself. There was no real reason, you know, quotes for me to be experiencing that pain. And there have been times, right, where I have come to you and I say, you know, I'm feeling a little achy in some particular, you know, or this week wasn't a great week. And then we talk about it, right? We talk about, well, what's going on? You know, have you been stressed about something? And there have been a couple of times where I've been in the soup, so to say. so to speak, right? I've been in the soup and I'm like, oh, dear God, it's true. And I would say the grand majority of people have pain because of another reason that they're not even aware of, right? Because we tackle on all these things, whether it's work and family and husbands, wives, friendships, whatever. And they do add a lot of stress. And sometimes the problems can persist. And in some cases, people get a divorce for that reason. But there are a lot of people who experience physical pain. It's not just emotional. I'm sad. I feel, you know, achiness in my soul. All of that applies. But a lot of times that manifests in a physical ailment.
Yeah. And I think, yeah, absolutely. And, you know, you could definitely get in the weeds and start to get a little woo woo on, you know, holding trauma in our tissues. And that's not necessarily stuff that I'm well versed in or as on board with, I guess you could say. But what I am on board with for sure is that the physiological effects of stress, of trauma, of emotions, of anger, of all of that, the things that happen when we're experiencing those emotions, absolutely impacts our physiology. And it's everything I did before of muscle tension, hypervigilance and awareness. Every sensation in our body changes in our heart rate changes in our blood pressure. And there's, so much more of the pain experience that has to do with the downstream effects of those physiological changes that kind of creep up over time. There's a lot of really interesting evidence and kind of a foray into the literature now about how much more metabolically related a lot of musculoskeletal pain is, meaning having chronic pain has a lot more to do with how we process nutrients, how we process sugars, how our body is using that as fuel, all of these things that can really cross over into our pain experience and into the musculoskeletal world. That's not necessarily my expertise, but just saying like, how much more is impacted and goes into this than we could ever slap on a label? Like, okay, I can't just give you a label of chronic low back pain or nonspecific low back pain is my favorite. It's just somewhere down here. Right. And it's just like, no, there's like a million things probably feeding into it. And really so much of it, if you can get moving, if you can find something that you enjoy, if you can decrease your life stress in some way. And I realized it's not always possible. You have to go to work. You have to have a relationship or relationship with others. You have to have stressful moments. You have to have maybe a family that you don't get along with. There's a lot of things that go into it, but if you can find things that bring you joy, that really does make a difference. There's one of my favorite things ever to do just to get movement in and then to also bring myself joy. I go on long walks and I listen to a funny podcast. I don't listen to anything that has anything to do with work. I'm not listening to people dissecting articles and all the things that I tell myself I should be listening to because it's boring. I'm not listening to anything at all that has to do with science or medicine or physical therapy or strength training. I'm listening to like comedians talk about their life and I'm just getting out of my own head and enjoying myself while I'm also walking, you know, to find ways to get back to those things, those simple human pleasures. And it goes along
It does. It does. So it's, it's really about movement. So the podcast is about life, love, divorce, and real estate and the intersections of all of those, because at the end of the day, we all live somewhere, whether you're renting or buying, uh, or, you know, your homeowner, um, you know, and life happens, love happens, whether you live with a roommate or spouse or, a sibling, a friend, whatever, you know, life and love happens on a day-to-day basis. And when it comes to, say, maintaining your relationships, your mood has a lot to do with that. And I tried to, you know, and again, that could be, that's another rabbit hole, right? That we could be here for another hour, probably talking more philosophy than anything else. But the point is, Pain usually, you know, we talked about pain being a red flag and about certain ways to address pain, but pain also puts you in a bad mood, right? So if you can prevent that, let's say prevent it or treat it in a way that is actually going to help you, that is going to help you get past whatever that situation might be, put you in a better mood. It could absolutely help you get through some of the tough moments. Like let's say you are in the middle of a divorce. Let's say you're empty nesting. Let's say you are just in a rough patch and you need to help you know, get through it. You need to, I don't know, have difficult conversations or make difficult financial decisions. You know, all those things cause stress, frustration, tension. And they can obviously exacerbate certain things that may be wrong, say, with a relationship. So I know that I'm probably reaching a little bit for, you know, sake of this conversation that we've had that's been more specific, you know, to, um, to training, basically yourself out of problems. Um, but because of the psychological benefits that it has, it behooves people to at least give that a try and just try to stay in motion as often as you can. I mean, it's, I think it's a side from anything else. It's a privilege if you're alive. Right now, it is your privilege to move around. And some people, unfortunately, don't have that because they've suffered a massive accident, some form of tragedy, and they're limited. So take advantage of what you have, that you are alive and well, and go for a walk, go for a run, try a new exercise. you know, push it a little bit and get your blood flowing. I, like I said, I love to feel alive. I love to feel that I am capable. One of the things that you well know, I don't like it's feeling like I have a limitation. Like when I broke this pinky, I'm like, great, what am I supposed to do now? Like, it's so frustrating to me to not be able to move in the way I want to. And I don't like, I don't like being held back. So I purposely move as often as I can and put myself in whether it's tearing this house apart, cleaning it, or, you know, going out to play an incredible game of, you know, two-on-two volleyball, whatever it is, I just, I enjoy moving. And I love that there's so many more benefits to moving that just saying, you know, I'm going to lose a little weight.
Right. Oh, my gosh. Yeah, the benefits are endless. And to speak to your point about when dealing with like relationship struggles and just the reality of something like divorce or something like a big life change. I mean, one of the best things that we can do is fortify our relationships with ourselves and treat ourselves well. And I really do firmly believe that activity and moving your body is one of the best ways to care for yourself. I mean you are just depositing love and care into your own person, which is really what developing healthy relationships with other people is all about too. If we can't do that with ourselves, if we don't have a healthy relationship with ourselves, with our body, with the amazing things that we can do, um, and actually being active and doing those things, you know, that, that changes our ability to have those really meaningful relationships with other people too. And I think we can utilize exercise and movement also as a way to like give back to ourselves. You know, we're used to thinking of it as punishment, like, Oh, I went out last night, so I'm going to go let all this off. And I want to flip that a little bit and think of like, Gosh, I get to move my body and I want to reward it by moving it more because like the deposit I'm giving and that helps with the relationship with us and with everybody around us.
It's true. It's absolutely true. I feel like my head is swimming with so many other things that I want to talk about, but I'm like, we'll be here forever. And I think the listeners would be like, Oh my God, is she ever going to stop? But, um, so I'll definitely have you back. And I think I would love to maybe even pinpoint some other things that maybe we didn't cover that we can specifically address maybe next time when I have you back on to talk a little bit more about how we can improve our, our life and our health span, our lifespan and our health span. Let's see. That's a good topic. So We'll do that then. Thank you so much for joining me. I love having you. Maybe next time we can do it in a studio and we can do it face to face, which would be fantastic. But until then, I will see you at Old Bowl. Thank you for being just an incredible, I don't even know what to say. You've been this instrument in my life that has really made an enormous impact, not just physically, but also emotionally. And I can't thank you enough for being there at the right moment, in the right place at the right time, and for just infusing me with all this information and all this good stuff. I'm feeling better than ever.
That means the world to me. It means the world to us at Old Bull. I mean, that's all we could ever want. Thank you so much for having me. This has been awesome. Thank you. Awesome.
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