12: What Really is Pain? w/ Mike van Der Laan
Thomas and Eric sit down with Mike Vanderlaan to discuss misconceptions around what really is pain, CrossFit, training athletes, and how to maximize longevity. Both Thomas and Eric came away from this podcast with new insights into pain management and training. Enjoy this jam-packed episode! Teddy bear bandaged up Transcript: Yeah yeah I said every time like we I don’t realize we’re talking to about three minutes. I’ve gone by yeah, well we’re going out okay. I’ll see you there you go walking to LPP episode number 12, actually we’re OTP we’re doing a slight name change, oh yeah, it’s right iTunes flag does everyone out there. I don’t even know oh yeah that’s why okay yeah so I am your co-host Eric Schroder, this is Tom’s Bows and we are with Mike Vanderlawn got it first try yeah from the lane and and Dutch yeah nice little history.Lots and before we went live here so Mike is been I mean we I got to introduce a mic up probably about three years ago through my former boss we had I’d really just I showed up to work one day and then there were two physical therapists in our gym and I’m like, I had no idea what to expect. I’m like why these guys here below? I know they’re actually kind of doing like a functional movement screen like in-house like a seminar but almost like a like a how-to and so they were kind of giving us better assessment tools and then in like trade. I know I think at some point we went back there we demoed like some like basic lifts. Some and how it’s application to kind of like return to play so that’s our first introduction together um is that kind of how you remember as well or yeah yeah it was really interesting I had heard from a couple of my patients in Hudsonville yeah we trained at the feet Creek factory, oh yeah what kind of lips are you doing what are you doing and now we’re doing deadlifts and this and this and yeah, well it sounds like really quality training. I got to know who your coach is yeah and so I looked up the free factory found your former boss and then that’s how we kind of got yeah set up yeah yeah that was that was a probably yeah, right? I think I was still in school the time. I was born 27 17.I would say um and then actually as of recently Mike and I’ve been working together he’s got to kind of deal with some of my nagging injuries aches and pains that I let go for far too long we’ll get into that later but if you want to go ahead and maybe give us this a little little backstory into you. I know you’re I mean traditional like DPT on physical therapists of you were originally working out a Hudsonville kind of maybe how you got your star we’re like how with your education came along and then the kind of how you got to where you are today yeah thanks so injured in high school and at that time my dad was saying, hey, I don’t want you to. Go into my appliance store like you’re not gonna run this you’re not gonna be a business guy the economies do up and down like going to the going the medical field so I get injured playing soccer in high school and PT is pretty cool you get to interact with people you get to stay active you get to exercise maybe this is the medical career that I want so from that stand from from that point on I kind of started down that road to get my DPT and that was really my goal in undergrad. I played soccer all through undergrad and just kind of worked on my exercise science and psychology minors and with the hopes of getting into a grad school.For therapy and I did do therapy and my doctor in Denver Colorado at Regis University and that school was really really cool because number one you’re in Colorado, yeah, you know, I love West Michigan but yeah the chances to see the mountains and stuff that would be awesome yeah but what they really encourage was lifelong learning and that sounds kind of cliche but more more so like don’t just get stuck in your ways and think you’re gonna do that for the next 40 years career be done, you know, you constant evolution learn how to read scientific journals learn how to kind of learn from other coaches and people. And so that’s the main thing I took away from that DPT was I just got to keep learning and growing. I can’t practice the same way I did when I first graduated. And so that was that was a really cool experience out in Denver worked out there for two years and then we had the birth of our daughter we said look we want to be by our parents won’t be by family. So we came back here, and I got a job at Hudsonville Physical Therapy, and that’s when I kind of ran into yeah Hunter and you okay? Yeah.Awesome. So yeah, I mean, that was.I guess I said roughly around three years ago that we bumped paths um very very unique experience I mean for me personally. I’ve always liked the PT realm is always fascinating to me because the most people I’ve worked at have been that kind of that strength coach piece as well as I like the return to play the fiscal therapy like the inpatient the the clinicals work. Maybe you want to touch on I know because you’re you’re you work a little different. I’ve been to multiple PT clinics before and um, not to say that they’re necessarily watered down but I I think maybe kind of bridging that gap from.Therapy to playing sometimes something is lost in translation between the two yeah, have you noticed that or what do you what’s your kind of philosophy on how that return to play looks like? Yeah, so the association for physical therapy the APTA came out a couple years ago and said well what’s the top five issues with physical therapy? And one of the biggest issues they found is under loading and essentially what they meant by that was we are doing watered down therapy and we’re not preparing patients for that next step. And for me that was kind of a big eye opener because you know there bands can be useful mm-hmm like all these different tools all these different modalities can be useful, however are we actually preparing people for real life? You know, they can’t do a fair band and then go expect to go to their job where they have to lift 50 pounds. If we don’t train maybe a deadlift or a squad or something a little bit more. So my big thing was trying to find that transition between okay where where is the nice handoff to the next person the strength coach and I don’t want to do it all because that’s not. My role my role is not to do speed like you do speed but my role might be early in therapy to set them up for you to kind of knock out the rest of the way. Sure and I think that continue on is different for every person but like like we said it’s more of like a continuum as just like here’s the line don’t cross it right or here’s a line don’t cross it time like you’re gonna have a lot of insight into how your athletes need to train and I need to learn from that. Yeah, I mean that’s like you said, it’s not like nothing’s ever so blood black and white that it’s like alright like you passed like you graduated.Today and that’s honestly I was for me. I remember when I broke in my back and had a bunch of disc herniations of one night. I was like, hey like you passed this this supine knee hug test like you’re paying free you’re good to go and I’m like right like 19 of my okay, this is interesting. So luckily I was trying to episode the time that did help me kind of bridge that gap so I didn’t really jump right back into things but I mean as especially as a kid right and like you talk about the psychology of it even it’s like all like,You might be told you’re ready but like you still don’t feel like yourself right and so I think where that kind of that gray area is is like that return to play where okay you like you pass all the the so-called tests like you check the box, but it’s like okay now how do we kind of build up that confidence build up that resiliency piece so that when it is time to come back it’s like how do we how do we make sure this doesn’t happen again or how do we make sure we’re not compensating somewhere else right, um, that’s tough. I mean that’s because like we run to a lot of this nagging little injuries, you know the whole overuse and youths like used sports has been just a disaster and you.’ve been like kind of coming out of covet here like we’re seeing I’m seeing this a lot of this like high volume like injuries where it’s like hey my hamstrings are always so tight or whether it’s like just like growing tweaks or just whatever it may be like I know baseball players like elbow pain shoulder pains been a problem and that’s like you go from nothing to trying to make up an entire season’s worth in about a month, yeah. I mean, what are you really expect to see and so I know you’re you’re kind of back in the clinic and stuff like that but like is that something you like the PT’s are talking about as well it’s like hey like this youth sports almost like epidemic like of hey like these over. Use injuries are getting younger and younger is that only on our end or is this something that you guys see as well yeah it absolutely something that we’re seeing in the clinic and and I I go back to even when I first started practicing I had these youth athletes that had specialized in baseball softball volleyball, they were terrible athletes yeah, you know, how did you get so far you’re on this club team you’re traveling every weekend, but you move like junk yeah you’re weak and you’re only good at your sport now you’re injured yeah because if they’re seeing me, they’re injured. I think we have a lot of nice scientific studies to say now that for most sports, not every single sport but most sports you’re gonna benefit from multiple sports yeah in solid training in the offseason and what we’re seeing is soccer volleyball baseball softball are very guilty of this where you are specializing year round. I think football is less so because football is a high school sport and there’s really not a league outside that’s popular here so so a football player says, oh I can go play basketball on the winter and I can run track and in the spring.And so football player actually has a really nice or they have a choice between track and baseball yeah but they have this ability to kind of do multiple sports and develop their athleticism yeah and that’s not what we’re seeing with some of these really early specialized people is that they’re not athletic and they’re not going to get a couch scholarship because they’re going to be broken down and they’re not that great of an athlete to be honest, yeah no we talked about this. I think last week even with are you familiar with? Dr. I think Greg grows is his name, he’s a lot of the the TPI golf world on yes. I mean, his big thing is always say early to ripe early to rob it’s.Like you don’t really care if the kids good at 11 years old and like we try to have that conversation as much as we came with parents here it’s like hey like I don’t care if it’s best freshman and West Michigan it’s like it doesn’t matter for at least some other four years so it’s like we should probably take our time and like develop that holistic athleticism over hey like I need this kid to go to the Little League World Series this year, it’s like yeah, it’s kind of we it’s it’s kind of like aligning those priorities and kind of figuring out like what is the goal and like you said it’s like did like do we want to burn these kids out and make them really really good baseball players or it’s like once baseball’s over then what yeah the numbers for dropout and use sports are as an all-time. High.And so we know now okay so adults not even 20% of adults are getting the recommended daily activity now when the youth it’s dropping off too, yeah and part of it is you sports burning out it’s not the only reason but they’re burning out and like that’s that’s their physical activity and now they’re not even carrying on past 11 12 because they’re so burnt out with a so having that long view is so so important, oh yeah, let’s just develop over time we’re in a culture of now parents want it now, but look. Kid isn’t gonna get a scholarship at 11 you know they’re not LeBron James yeah that’s a easy scenario you know Tiger Woods LeBron James those were unique scenarios where they you could just tell they were gonna be that good that early yeah those outliers and people use this like they are outliners yeah that’s yeah that’s something we try to talk about all the time is just like, hey listen like don’t like like just because you see LeBron James doing like squats on basketballs, it’s like he could literally do whatever he wanted he’d still be the best basketball player in the world you give him a kettlebell he can do whatever you want to get it’s not gonna make him. Worse yeah well a couple years ago there’s some controversy over Usain Bolt’s training regimen he posted some videos online people like oh my goodness that’s terrible training yeah you’re arguing with yes right in the world yeah at that point it doesn’t really matter if he thinks he’s getting what he needs to sprint really fast don’t mess with that yeah and if he’s asking to change and he’s ready to change okay, that’s that’s different but you know at that point when you’re at that top, you’re point zero zero zero one percent yeah people you can get away with anything it’s yeah sorry, no that’s whatWe don’t glorify athletes training regimens yeah they might be really good or they might be really crappy yeah just tough because they’re the they’re the status symbol for youth it’s like yeah that’s who they look up to in 2010. New Orleans Saints coach. Sean Payton, yeah obsessed with crossfit wanted all his players to come you guys remember this design yes. I do. I remember yeah, I guess I remember what John well born he was a former NFL player and then he got in the cross with scene and then shortly after realized like this is fun, but this is not how any athlete should ever train it’s just like,That when boring vanilla middle zone that you want to stay away from and it may have worked for a few of the athletes because you know whatever they did was gonna work for them right yeah yeah, we’re going back is it optimal is it ideal no let’s not let’s not teach our youth that like this is the way it has to be yeah no it’s it’s sorry that’s our true and it’s that kind of like that one size fits all where it’s like that’s never been training that’s never been therapy that’s not I mean like really like how the more like we talk about being good generalist before you could be good specialist, but it’s like you died like when it comes to individuals like that’s what you’reTraining humans first like so it’s like we need to kind of meet them where they’re at rather than meet the program fit what they need what we want them to accomplish right but no that’s that’s interesting the whole like we done we talk about crossfit all the time just being like,Like what’s the way what’s the difference between optimal and fun right and like in you you actually do crossfit don’t you and like you yeah which a little bit as long oh shit. I went through the level one certification and all that I think and crossfit comes in a couple different flavors sure if it comes with a die-hard flavor which is you know, the folks who are really following everything that HQ or headquarters is putting out they know all the athletes and they they take that training that they’re putting out in involved to a team. I think that’s one category or one flavor across it.My flavors a little bit different. I kind of look at it as it’s a community of getting people more active with barbells and maybe some other fun stuff in there and so for me if we go back aways barbells were considered pretty much a power lifter tool mm-hmm how many women when I was when I was training how many females how many older individuals did I see with a barbell at the YMCA growing up very very. I feel one. I want to tone. I want to do this. I had the date of the small weights and the high reps.I think one thing that Crossfit and they’re not the sole proprietors of this but they’ve empowered people that want normally pick up a barbell and and lifting some heavy things yeah and now we see all the bad, you know, we see the bad technique on YouTube yeah but I think that’s the price you pay you’re gonna have that execution error with anything mm-hmm, but what I think it has empowered is a whole class of women and and older and younger people saying, oh I’m comfortable with the barbell, my mom does it my dad does it my grandpa does it so I think it’s a little bit more accessible. Now than it used to be and I guess I’d say that’s probably one of the best things to come from it yeah and another benefit is it popularize Olympic weightlifting to whereas yeah and we talked about that with Alex like who cared how much someone could snatch ten years ago, yeah it’s like now it is on TV, it’s not ESPN yeah, yeah. I mean it’s definitely done and I we’ve said this before it’s done more good than harm to degree right but it’s like when people kind of like I said kind of fit that square peg in around whole where it’s like all like this is the answer and it’s like,Well no and like even if you look at like how they define like high intensity movements or what or whatever like rotating exercise it’s like well like sets of ten snatches like aren’t high intensity because like you look at like the heat like the velocity of the bar it’s like you have to move it a certain speed otherwise it’s not getting off the floor so it’s like by nature it’s not even at high intensity lift so it’s it’s just I mean, it’s like it’s educating people. I mean, we like you said you’re always gonna run those technique issues but I mean realistically like I weigh rather have someone do that and some other couch right and it’s like you find like you said there’s kind of like the spectrum of coaching where it’s like, I know I got. Confident Alex like hey like if you want to dink around with some of that in our group like I trust you the point where you’re not gonna get anybody hurt right and that’s always been like rule number one in any professions just do no harm so we’re keeping people safe and improving the quality rather than decreasing the quality of life or even increasing the chance of injury then we’re doing okay, yeah and I think you’re absolutely right on about definitions. I think the definitions really get morphed a little bit yeah, especially with big personalities yeah in the upper that you know, they talk about velocity or they’re talking about power and they’re really not defining it like it traditional.Should.In a physics that correct because one thing I’m learning from you like, you know with max power is gonna come a ton of rest yeah ridiculous amounts like boring amounts of rest yeah yeah yeah and and that is absolutely not something that the crossfit understands so I would say, you know for they’re working a lot more middle when they’re saying it’s high yeah middle intensity yeah no that’s exactly right and and and that but if you call high intensity people are gonna call high intensity right, so yeah the definitions matter and and their bastardized. Definitely so how do you bridge because you I think you have a good understanding of that that dynamic of training how do you bridge that gap of like here’s the cross out work out of the day and then how do I coach these athletes yeah we so our gym doesn’t follow the headquarters, okay follows a program called comp train and it’s decent but it has some some major flaws. I bridge it with mainly going way back to what we’re talking about earlier is having a long view, you know, people want to come in and they’re say they come in and February say I want to be ready for March because I got a I got a cruise, mm-hm. Classic yeah right yeah like well you know I’m I’m approaching it from what where do I want to be at 40 with my strength and with how I feel where do I want to be at 50 what kind of lifting can I do into my 70s and my approach is kind of that long view of yeah. I want to have a great physique who doesn’t right yeah but at the same time I want to feel good throughout and I want to be able to lift a barbell when I’m 70 yeah and so how do I do that so I take that into my coaching kind of that long view and and try and explain the long via look here’s what it says, you’ve. Should lift you’re not at that level yeah don’t even try yeah or let’s say hey we got a snatch today you can’t get the bar over your head safely, let’s not do that mm-hmm let’s focus on your front squat technique or let’s focus, you know just pairing down the movement so I’m a happy to modify kind of guy as opposed to the prescription is what they call it, you know, here’s this workout you need to do this and I say but you’re here yeah and that’s okay, yeah, it seems like the headquarters prescription is like struggle struggle to adapt. Like you’re gonna struggle through the workout and then eventually you’re just gonna figure out how to snatch it’s like at least in my experience being there and yeah a lot of gems but I think that’s huge to pair it down break it up and also like if you have a coach who’s helping you be like it’s okay, if you don’t do the workout that’s huge because if you go to the gym, everyone else is doing the the wad you’re gonna want to take part in it’s just that yeah just how it community pieces daunting yeah right well and it also goes to the individual’s goals, you know, if they’re goals are just aesthetics or just physique do I need to worry about normalizing their overhead. Squat to get it to a certain weight no I don’t care about their overheads yeah I don’t care at all so we’re not gonna focus on that whereas someone who’s training for a competition, we have people that a couple people I like to do competitions, hey we might actually load up that overhead squat really coach it yeah otherwise we’re not even gonna go there and I think that is a that’s it all comes on a coaching yeah, you know, do we understand an engine individual’s goals my goal is not to compete in the games or a competition my goal is to look good feel good and enjoy myself and get stronger yeah. I have a couple, you know, strength goals that are.Out.The future That’s my goal So do I care about my overhead squat Absolutely not Yeah Well I do it Yeah I’ll do it but it’s usually pretty light and usually I just focus on technique, right? So that’s awesome. No, I think that’s a really good view because I mean yeah we’ve done our fair share of talking about crosses in the past but I mean like you said, I mean the definitions matter the the coaching approach definitely matters and knowing just for anyone like meeting them where they’re at like, that’s always gonna be probably priority number one mm-hmm, but that’s cool. I know like in that space like, how do you like?About a session what does it look like what if you’re coaching like paying pops up right and this happens a lot right They come in like hey Mike like I don’t know what I did but like my hamstrings just tired like I feel like anytime I try to go run like it feels like it’s pulling like that’s something we run into all the time just as kids and it’s usually not until about halfway through and I’m like, hey, like how long has been feeling this like all like three days ago and like they didn’t say anything at the beginning of the session so you’re gonna get you’re having to kind of watch and find out but in terms of like what is pain for you and what does that kind of mean to you and how do you use that in what your work kind of like definition that’s like that’s a great question it’s also. Volcano worms yeah yeah, let’s open the can of worms yeah pain is very very complex yeah and I want to go back and kind of history in the health care from a health care point of view we have completely gotten pain wrong since sense of since you know, hundreds of years and I’ll explain why but traditional health care we rely on a biomedical model biology medicine, right? And so when we talk about pain from from a biomedical perspective, it’s your tissue is damaged therefore you feel pain mm-hmm that’s kind of where the buck stops okay, so how do we how do we fix that we we help your tissues heal and we try and stop the pain with medicine mm-hmm or we try and do a surgery to fix the tissues intervention yeah yep so biomedical approach to pain is is almost always going to be an interventional approach to pain when I deep dive into it after school kind of that continual learning we find out that. Breaks down really quick and and how it breaks down as pain is super complex so chronic pain sufferers horrible conditions you know people don’t go out of their house with chronic pain thirty percent of those people have never had a physical injury that started it that’s interesting well, let’s look at third you’re looking like almost a third a third of people have never had a physical injury that started that chronic pain and so what we’re learning is yes, the biology is poor important and don’t you know patients miss here this all the time and it’s my fault. I have to clarify this the biology is definitely important in pain.But it’s not the only thing and so what we started to include in pain what else contributes to pain well the psychology and then the social emotional so we called a BPS mile BPS model and this is where healthcare is really going or should be going but taking the biology and saying yes this is important but it’s not the only thing now if you go out and get hit by a car and you break your leg the biology is very very important in that context, but six months down the road the biology, you mostly healed your bone heels and eight eight weeks or so. The tenons of ligaments all that stuff is healed up and about 16 weeks so you get outside of that then why do you still have pain yeah and so the biology becomes a little less important and then it becomes the psychology and are you supported socially so let’s say for example, you didn’t have insurance and you felt really bitter to the person who hit you and so there’s all sorts of psychology behind that of I’m the victim here yeah, they should pay for this. I’m the victim. I can’t believe this happened to me and this is what we see with pain this this can kind of perpetuate the pain now.You’re not like that yeah you’re very independent you’re very resilient and you got support so you go get hit by car, you’re gonna get better and you’re gonna be on your way, okay, you might have residual effects, you know down the road a little bit of pain, but it’s not gonna become this chronic. I’m gonna be in a wheelchair but what I saw in my chronic pain program that I was a part of for a couple years is those people would be in wheelchairs well for for injuries that have healed because of the psychology component right or they’re in a wheelchair and they never had an injury. Because just the psychology okay that’s interesting that’s very interesting so going back to your question you know how do you how do you treat pain my number one goal is to encourage resiliency with pain pain is a part of life it’s normal we have to have it we don’t grow we don’t you know without stress we don’t grow without pain we don’t have a human we don’t have a human body yeah. I mean, we’re gonna feel things it’s information if I stub my toe or I step on a nail that information is oh my goodness, there’s a nail in my foot. I better go get a tetanus shot yeah, but guess what I go get my tetanus shot it’s gonna calm down. A couple days I’m gonna be on my way if I didn’t go take care of it if I never received that information I get as might lose a limb, you know or bad things can happen so I think I try and teach people that pain is information but we don’t need to go down the rabbit hole to the very end of it mm-hmm take it forward it is maybe I’ll back off in this training session or maybe I’ll kind of work through it and it’s going to get a little bit better let’s just see how it goes and then if it’s a dangerous type of pain, we’ll take care of that medically put the goal is not absence of pain or the goal is not as a pain. And that’s where our culture gets it wrong we see it on the billboard headed downtown back pain go to a chiropractor back pain you need surgery and that’s the wrong message matter of fact in Australia, they did a study in the 90s and just in one region so it would be like a state here they put a billboards the same back pain as normal wow they saved their health care system over a hundred million dollars the next chord your job because people read that they said oh it’s normal work through it yeah or subconsciously they’re like, it’s a weirdo or whatever we do what have we done with pain. All back pain needs to be treated yeah and there is back pain that needs to be treated but it’s it’s it’s overtreated and America and that’s that’s our problem and as health care clinicians we need to be coming there and saying this pain is abnormal let’s work it up let’s go take that extra oh yeah we we’ve got something that needs to heal we need to you know treat that appropriately okay, that’s one type of pain, but that’s only about 10%. Ah 90% of it specific to the low back is just going to get better mm-hmm but we over treat it yeah and then that psychology comes in. I’m a victim yeah all that doctor screwed up my back yeah now I still have this yeah all that surgery screwed me up now. I still have this pain yeah and I see this in the older generations who really relied on doctors and trusted everything they said it’s a little bit different for our generation. I have a lot more skeptics in our generation, which I think is great yeah like if you come in and question me, that’s you that’s great like it’s yourBody you don’t have to say everything you don’t have to take everything I say and and go go, you know challenge me on it yeah right right so yeah that was that was a long windy road oh that was incredibly helpful. I think like wow, like I’m just thinking cuz I mean, I got a mom a little back man. I can’t tell you girls come in here like all like my back hurts and it’s like to even tell somebody that’s normal. I’m like right now currently have a girl who’s like soft shuffle from pretty bad like shin splints and I mean, it’s been like over a year and like just tell her like hey like,Like this is tough but like this isn’t permanent at all and it’s and I got like I taught my hey like listen like like you can think like this is terrible like if you keep thinking this like this isn’t gonna go away yeah you you hit the nail on the head right there because the and this is psychology this is for a lot of our depression anxiety not all of it, but this is with pain is it’s not permanent but what happens to us pain sucks, yeah it’s unpleasant. I mean, it’s a very unpleasant sensory experience nobody wants it but when we’re in it, we tend to get short-sight and say, oh my gosh, this is never.Mind yeah and that’s the that’s the narrative we tell our son but it’s a lie because it will go away yeah yeah that’s like the suffering state is you’re holding on to that yeah. I’m never gonna get out of this this is awful yeah that was you know, I’ve had peaks and valleys with emotions the last four months with covet, yeah being you know losing a job and and you go through a little anxiety and depression go through that and you you sit there and you go this is it’s not gonna get better yeah guess what that’s a lie yeah and and and I think if we can show people not even patients but individuals like in a training. Session it’s a lie it’s gonna be okay like don’t don’t react yeah just work through it it’s not it’s not forever they can say okay and relax and guess what they’re gonna get out of it quicker yeah yeah that’s yeah so true. I mean that wow that was really well said I enjoyed that I mean for me it’s like it’s time to come let’s get that message across the younger kids right because like that’s everything is so now and even like we had talked about a couple weeks ago like Facebook and be like, oh man, like just the negativity and just like how that it can like how that can trigger like the anxiety the depression and just like,Like where your mind goes your body’s almost gonna follow right and like I’m sure there’s studies to back that up as well I mean you’re in the literature much more than I am but like it’s just so like what you feed yourself and like it’s gonna go a long way to how you feel um both mentally and physically, right? I mean, we talk about food like diet nutrition like hey like that’s gonna play a role on how your brain works and like if you’re not feeding yourself good stuff like that’s gonna trigger emotional like unstable responses at times and like we I’ve seen it before but almost like I mean in your experience, like I don’t know how many youth athletes you would necessarily work with but I mean, like kind of,I. Necessarily framing like that long term for them like how like what’s the like what’s been successful she for you in the past or it’s like hey like you’ve had this acute to get like borderline getting the chronic pain it’s like okay like how do we kind of flip that that’s psychological state and like kind of show them how where this can go and like how it’s not permanent? And and that’s the difficult part and that’s that’s really where it all comes in as.Finding what that individual needs as a goal like what are they working to and if you can kind of frame everything around that well this is why we’re doing this because you said you really want to you know excel at tennis or whatever that support may be or this is you really want to be out of pain, okay, what do you need to do to get there what things are in your control and I think it’s giving people some control. I’m gonna handle this stuff. I’m gonna do some tissue work with you, what are you gonna do are you gonna go sit on the TV for the rest of the day, are you gonna go for a ten minute walk like I asked you to do yeah, so I think it’s,Fine in the goal and then. Bringing them back to that goal well this is why we’re doing it and if they can kind of see that they’re able to flip a little and say okay well I’m working towards my goal here I have a ownership. I have some chain in the game now this yeah at the same time he’s got my back he’s gonna do the things that can help me get there, mm-hmm. I don’t know did that answer yeah. I mean you kind of like you said like giving them ownership of it right because you try to do something for someone like, you know oftentimes like it goes a long way, but at the same time it’s like it’s never gonna have the same effect as giving them a piece of pie and like and then like you said that social aspect just,Creating some semblance of security um I think that’s a good something a good way to look at how and the never thought of it like that but because I mean I think we’ve talked about this afforded wanting it being in this profession like you want to help people right that’s why you got into this um so the temptation is to do everything for them and I mean, I know I’m so guilty that I go out there someone’s a goal my hamstring. I’m like, oh I can fix this like right now like they don’t even need to think but then it’s like they come back two days later like they felt finally they left and then they come back they said still hurts, oh my god man, like I gotta do this again like figure it out, it’s like well, what did I tell them to do when they went home it’s like what did they do when they went all? So it’s like creating that kind of that it’s that maturity almost or like that like that buy and because it is tough right you think like some kids like depending on their age you don’t really know how much they can handle and you want to give them the benefit of the doubt but sometimes like just they’re gonna do what they want to do at the end of the day, um, it’s like letting letting them see it before you solve it you try to solve it yeah you want what’s like you want to position it to where they’re figuring it out yeah rather than you’re telling them exactly what to do, yeah that’s the mark of a great teacher, okay, you know, if you think about some of those kids in school that really,Excel sometimes their teacher is a little bit more hands-off letting them figure it out as opposed to the kid who’s getting tutors and being you know, just really being force-fadding. It’s it’s stuff though because you have a lot of knowledge and a lot of training you want to help people yeah and so how do you balance that with what they need and I’ve gotten it wrong so many times I’ve gotten that balance wrong where have you either given too much or not given enough where I thought yeah, I want to encourage this independence. I want to encourage this resilience and this person walks away and be like well, he just left me.Yeah and I had to balance on sale my goodness I have you know I didn’t give you as much as you needed I needed to follow you a little bit longer. We needed to go a little bit further or the other person where I did all the tissue work and you know everything and God I’m feeling great but then they didn’t learn anything. Right. Yeah, and they think okay, I gotta go to PT to get fixed. Yeah, that is not the narrative we want. Yeah, that is the medical narrative right now and we we have to flip that mm-hmm if we’re gonna have a healthier population. Well, even though sorry the complications that come with the term doctor,It’s like you go see the doctor what does that mean? That means you’re gonna be healed. Yeah, so it’s like correcting that whole stigma. We caught stigma but.That psychology behind that piece of like going the doctor or when you pull the athlete aside they’re like oh I get special attention Yeah Yeah no that feels nice like hey I don’t have to do the actual sprint like I do the drills instead like that’s not nearly as hard and like you want it like I said you want to give them a benefit of the dow and they be like they want to be here and like I’ve had people say like I like doing the sprints here like I just really hurts and I’m like, okay. But no, that’s I mean, it’s tough like they like doctors have a great business model. I’ll give them that right because like they they have this like almost God like complex where it’s like all like you’re the dog.After like they’re gonna they know everything and it’s like you once you start to dig in I know like you’re very familiar with like almost like Joe Rogan and Dr Ronda Patrick how she talks about like the lack of nutritional training in the med school or even just like sleep studies or like unless you specialize in something like that like you never gonna see it. Yeah, like they know they know prescriptions and medicines and like that’s kind of the test retest monitors like hey try this for a month, we’ll come back we’ll see how you feel and it’s like that doesn’t work all the time. Yeah, and I think I think that’s one of the biggest criticisms of a lot of different professions is you have people that think they’re at a higher level than they really up. I are We call that like a done and cougar effect Okay where you think you’re more of an expert than you are but when you’re truly an expert you realize how much you don’t know right and when you realize how much you don’t know you can be very effective. And I think in our culture we look at doctors and we kind of put them on up at a stool but there are good ones out there saying look, we don’t know a lot of things. Yeah, and if the narrative change a little bit and said, well, we don’t really know and people could accept that more and we’d have a lot healthier relationship with our medical community. Yeah, you know that even goes back and we’re not going to cover, you know,The last four months because it’s just absolutely insanity Yeah if if people understood that hey, this is what we know and this is what we don’t know. I think there’d be a better response because we don’t know a lot of things, right? We don’t know a lot of things about return to play protocols still yeah. I mean we’re at the very tip of it, but at the same time we don’t know how effective they are quite yet. Yeah because there’s a lot of individual it’s hard to do randomized controls, it’s hard to do meta-analysis of the randomized controls. It’s hard to do science and good.S.Going to be out there saying look we don’t know a lot of things This is what we don’t know We think we know this Yeah And if people could say oh yeah the you know we don’t have this pedestal instead of this doctor’s very humble and saying well, I think this is a good option here’s what we don’t know about it. And that’s even true about the medicine. We see this all the time people go into the doctor and they get you know script for you know, the next month of this pill. Is that ever been talked about you know, all the things we don’t know about it. It’s just that this will help this. Right, right and you just what do you do? You said there you go. Like he’s a doctor.And I mean even with statins one of the most well-researched drugs there’s still a ton we don’t know about it. Yeah, and that’s a whole class of medication that like almost everyone over fifties on right, you know, so there’s a there’s a lot known about it and here’s why maybe it’d be beneficial for you and and here’s what we don’t know about it and I just think if we could be better about that then the people that are coming to us we could have more a little bit more better relationship. Absolutely. But right now, I think it’s still I need to prove myself this is I do know a lot.And I think it’s still flipped a little bit I was tough if you have ten years of medical school Yeah, I use yeah, yeah, I can’t imagine the feeling getting out the other side of that feeling okay, like finally here we go right now it’s time to prove myself and yeah, honestly the the schooling system sets us up a little bit for failure with that. I was practicing and as in my third year practice, so as it would have been in 2016, and I wanted to quit I got to there. I don’t know anything. Yeah, there’s literally and and that was a good spot for me to actually be because I went as a new grass and I know. Everything and I was yelling at this person about this person about this and I was on my high horse because it’s what I learned in school. And then I realized oh there’s more nuance there’s more nuances. Yeah, there’s more gray and then I and then it took me two more years to say comfortably to a patient. I don’t know. We’re gonna keep looking into that for you. But what I do know is you can get better. You know still framing it positive, right? No this but I know you can still improve. Yeah, and I think that’s comes back to what you said being a great teacher like every great teacher’s afraid to say. Not afraid to say, I don’t know and like at any coach. I’ve worked around that. I’ve had even look up to or I’ve been like hey like.You used to hold them up like if the light like they’re great coach like they’ve said I don’t know like I’ve been to seminars where they people ask them around the spot where God I can’t help you Yeah and it’s just like I think we think like especially after all that training all that school and like we feel like we need to know and it’s like to say that as like we’re more worried about us like that we don’t like that like they don’t really care as much right? Like you because you think they’ll go home though Google it or they’ll go ask somebody else or like but even to say okay, I don’t know that let me get back to you like let me check my notes like something like that could go such like such a long way and even just building more trust right because like now you’re not lying to them and giving them false hope. But that’s tough yeah and I think we get a lot of people frustrated and it is either false hope or they feel like they’re being lied to yeah and to earn trust. I mean that is such important thing for business my dad always says, you know, my business is really unique because people have been to the big box stores and got burned so they don’t trust them yeah, they come to me and they’re already more trusting of what I have to offer because I’m small and I’m agile, and I’m you know, I just shoot straight yeah and so he said my my sales are easy becauseI have already earned that trust why not being something else right I don’t know that’s it’s just an interesting to think about that’s very interesting no there’s there’s something to that right I mean there’s not it’s not this scripted sale where it’s like hey I have this 18 year old kid saw me a TV it’s like no like that’s the owner right there like he had like you not like there’s like creating that security and that trust. I mean that like formula what is it like people only buy for people they know like and trust so it’s like you check off you start to check off one of those boxes like those other two are gonna follow along pretty quickly and I think I mean even especially for us like we only get sometimes like two hours ofWeek and I don’t like saying with you guys you’re working in these these small finite time windows per week and it’s like hey like not only do I have to treat but I also have to develop this relationship develop this trust and find a way to get this person to like me and know that like I’m on their side mm-hmm that can be tough because I mean, you don’t know what psychological baggage they’re carrying you don’t know if they even care if they want to get better like you like they could just be there because mom and dad said, okay, we need to get this fix and it’s like,Getting somebody to do the work sometimes that’s gonna be the biggest battle of the pizza like it could be some stupid small injury that could be so easily curable but it’s like they’re not gonna put in the work this is never getting better what’s I think it’s so interesting that you brought up like pain the pain component is more than just the biology is psychological so we have an opportunity now someone has pain it’s like let’s not focus on the biology first hand, let’s talk about like where are you mentally yeah, are you an exam week, are you stressed about covet, are you nervous about this that or the other thing and like I have a person? Al story when I was in track that corn stone university like six months and I felt like it was my job to report to my coach my pain like hey, I got this pain so I’m treating it and I’m not gonna do the workout today, but I’ll be blind and just carry it on and on and on I can tell you it’s getting frustrated it’s not changing and eventually I just had this moment of like,Hey coach I have pain I’m just gonna do the workout and it was like at that moment the pain started to go away it’s like so interesting that is interesting yeah yeah, it becomes it becomes an identity, it becomes kind of a self-fulfilling prophecy as we kind of hang on to it and it’s because we tell those lies to ourselves it’s never gonna get better mm-hmm now, you know, this is all within respect to their serious pathologies that you got to take care of right away right but in my experience in the literature, they’re more rare and you can usually diagnose them just by. How.Person will tell you it is But generalized pain or pain like in a low back typically is going to be one of those things that we don’t want people to hold on to So you here are setting the stage for health care practitioner to knock it on the park with someone. They would say they go further a yearly check up and they haven’t been in here training. They say yeah, I got back pain and doctor because all my goodness we had to treat that. Yeah, you know and then they’re down that funnel or they’re in here training like yeah coach I got some back pain and you’re like, you know, I think you can work through it. This is these exercises are actually really good for your spine. Yeah.And you set that Now when they go to their doctor and say yeah Doc I got some back pain, but I’m okay, I can still do my stuff. Yeah, then the dog’s not gonna send them, you know overreact yeah and go back to what I was saying earlier about there’s a lot of over treatment. So you you guys earn a really unique position to to really help the youth change shift the culture a little bit. Not only with pain but just general activity having a longer view. These are really important things that we’ve gotten wrong for a long time. Yeah, definitely trying to rewrite that script. A little bit um and it’s top right I mean it’s nice It’s never nothing ever moves quickly especially when you are thinking with the end in mind but um yeah it definitely helps seven people of similar mindsets around this area for sure. I mean you want to talk about maybe a little I know we’ll start wrapping up here in a minute, but um kind of what’s what’s next for you we kind of spoken off camera a little bit of what was popped up for you you want to share whatever you’re comfortable with on that. So the main thing for me right now is to get back into work. Yeah, treating patients getting comfortable and then kind of learn from some management. I I like you I want to set up.A positive culture Yeah I’ve been in good cultures I’ve been in bad cultures in my workplace and and again, I I would enjoy setting that workplace culture. Yeah as a place that can be a real positive thing. So in my future, I’m looking towards that obviously the last four months have put a kind of a dink and everybody’s plans sure but they’re where there are problems there’s also opportunity. Yeah, and and so eventually I’d like to have kind of my own thing whether it be with a big rehab company or something different mm-hmm that can offer, you know,This messaging and in this messaging will evolve a little bit over time but some of something similar that’s a positive messaging for for people. Yeah, and and help them get the health care that can can really benefit them. Yeah, awesome not super helpful. I mean definitely going down the right path and like you said, I think this is gonna be interesting to see how people come out on the other side of these like I mean this past four months like you said, I mean, it’s kind of be that resiliency component where it’s like hey who’s gonna come on on top? I mean, this was that test for what do you wanna say personality like?Businesses even like anything. It’s like if you can come out on the other side of this like you’re gonna be probably doing okay for the rest of your life, um.But now thanks we appreciate you had coming out here Mike this is an absolute blast and having someone who’s a wastewater that I’m supposed man you give me way too much credit no you guys know your craft and you don’t really well and and that speaks volumes because you you have people walk through the door and they know the product they’re getting yeah and that’s not everywhere and that’s a really special thing to having West Michigan so we’re now I’m excited to keep learning from you guys yeah did. I mean say it goes both ways for sure happy the last time yeah that’s for sure well thanks for sharing your knowledge and your story you have a yeah a place where people.Yeah yeah, so I have my own website where I do some seminars weekend seminars, it’s Vander Vanderlonphysio.com, and then I’ll be starting with IV rehab and the Coopersville clinic and I’ll probably be doing some some stuff for them as well, so that’s where you can find me and then Twitter Vandy. _ Mike yeah love it we’re getting on Twitter and then we’ll yeah eat a lot but I do follow a lot of people that are interesting yeah Twitter, you know from a business perspective not worth it but as an individual. Financing some coaches and in other if all a lot of doctors yeah, I can kind of get this incredibly helpful for some of us stuff that’s coming cool, well we’ll like that in the notes below but yeah, be sure to check out his stuff great stuff we’ll look to have some seminars with him actually at our facility here in the future as well as things kind of calm down a little bit yeah, thanks for watching guys, thanks guys, thank you.