Whole Body View Podcast
How many times have we been sent to get a knee checked or a hip when the reality is the whole body should really be getting evaluated to get a true understanding of where that root cause is coming from.
CEO and Founder of Structural Elements®, Doug Bertram, doesn't always believe that these separate issues are separate issues. He likes to look at the body as a whole to see if our pain or discomfort could all be related. He states it like this "a body may not be a series of injured parts, but instead a body as a whole". Meaning we have to look at the whole body when assessing how to treat a problem or we might be really missing the big picture.
[00:00:01] When I go back to edit interviews there, sometimes these moments where comments or suggestions or insight recommendations just feel like they're highlighted or that they pop out to me. And so I always like to bring that to your attention before we get the episode started. So you know what you're in for. And some of the things that I was hearing today were focusing on the goal that the client would like to achieve, not just focusing on their symptoms, quit beating up the part of the body that hurts this visual made me laugh. I bet you can picture the same thing, having someone dig their elbow into a sore spot or the back of your neck. Quit beating up the part that hurts everyone is an athlete. Isn't that awesome? Whole body view. Never just focus on the specific injury. And our interview today, I bring you Doug Bertram, a massage therapist who got his masters in traditional Chinese medicine. And he started a franchise called Structural Elements®, a way to bring the best modalities to the forefront, giving practitioners the ability to decrease time spent healing and more time spent living actively. You will hear talk today on bio individuality, big picture posture where we have our head back, open shoulders getting the center of our mass balance. We have torque on plantar fasciitis, fibromyalgia and so much more. If you want hope and insight that we really should be seeking daily, stay tuned. [00:01:33][92.2]
[00:01:39] Hello and thank you so much for joining me. I am your host Lindsey House, registered dietitian, private trainer, accountability coach, author. I have been working with clients for over 13 years, passionately changing the culture of health and fitness. I'm out here smashing scales, helping individuals rewrite the rules to what success looks like in their life. I want to change generational thinking no more all or nothing mentality. Get rid of diets and believe in individual journeys. We are stronger than we will ever accept and beautifully made just the way we are. Keep your eyes on your own paper and trust your own fat. Thank you for trusting me and letting me be a constant encouragement for you. Let's get this motivation started. Welcome to your podcast Direction, Not Perfection. [00:02:25][46.3]
[00:02:32] Happy podcast Friday, welcome to Episode ninety eight, a whole body View, you are in for a treat today. Get out your notepad because there's so much content coming your way. Have you ever had multiple things hurting on your body all at once? Our interview with Douglas Bertram has some really fantastic insight for you. Doug doesn't always believe that these separate issues are separate issues. He likes to look at the body as a whole, as the whole body to see if our pain or discomfort could all be related, he states it like this, “A body may not be a series of injured parts, but instead a body as a whole”, meaning we have to look at the whole body when assessing how to treat a problem. Or we might be really missing the big picture. How many times have we been sent to get a knee checked or hip when the reality is the whole body should really be getting evaluated to get a true understanding of where that root cause is coming from? Wouldn't it be nice if we didn't need a script for every separate body part to get checked out? I mean, I can speak from experience on this. My husband could speak from experience. He went in with an issue and he knew he had multiple questions. But literally the doctor wouldn't answer multiple questions. He said, your script is for this. Let's talk about this today. And then if you'd like to talk about the other parts, then, you know, go back out and go get that script and then we'll talk about it. Where to me, I witnessed this within clients and I feel like, wow, that's enough for somebody never to come back. Like I said, I sometimes have enough trouble keeping my clients feet held to the fire of getting that appointment in the first place and then to think that they're going to go through the trouble of getting back out the door, getting another script, scheduling another appointment, like, oh, holy cow, that just seems it's too much. So if we could walk into a clinic where all of our needs are available for care, wouldn't that be amazing? Doug has a focus with athletes, but he believes we are all athletes and I love this. And whether you are a mom or a dad, a grandparent or kid, this message really is for you. I'm excited to introduce you to Doug, but I am first going to announce our Listener of the week. This is from Quindaro. You won't find a more sincere, positive, professional journey to better health tools for navigating the journey called life are added weekly encouragement for being wonderful right where you are. Wow. Offering guidelines and tips to help you reach your future goals, fitness or dietary. The podcast generally brings interviews with other specialists that cover the gamut of topics for better living. I look forward to walking and listening to Lindsays podcast each week and I think you would do. Thank you. OK, Wendell, you seriously are simply the best. Thank you.
Let's introduce Douglas Bertram and get this interview started. Doug started working as a massage therapist in 1995 with a focus on treating athletic injuries. He practiced for several years in Boulder, Colorado, before pursuing a master's degree in traditional Chinese medicine. He started his training in San Diego, California, where he maintained a busy orthopedic practice and then later moved to Santa Cruz, California, and finished his degree at five branches university while a student in Santa Cruz, Douglas, was able to grow another substantial practice. Several fellow students approached him with questions about how are you building your practice so quickly? These questions led him to evaluate what he was doing differently from other therapists, which may have contributed to his success out of his exploration. The birth of a unique approach was born. Douglas has always viewed the body as a single unit. He believes that the structure dictates function and that the body thrives on efficiency from early in his massage career and central to his Chinese medical training. Douglas works primarily with the connective tissue. He developed a unique mapping of where the body forms something called focal adhesions, a thickening of collagen and responds to mechanical stress. After graduation, Douglas returned to his hometown of Milwaukee, Wisconsin, and joined an integrative practice. He practiced in Milwaukee for five years while developing and refining the structural elements approach. Structural Elements is a highly effective clinical approach to balancing the structures of the body. It is used as a combination of acupuncture, which is also dry needling, manual soft tissue manipulation and joint mobilizations to restore proper structural balance. Douglas opened the first Structural Elements Clinic in August of 2013. Doug's passion is mentoring and educating to bring the best modalities to the forefront, giving practitioners the ability to decrease time spent healing and more time spent living actively. Please help me welcome Douglas Bertram. Are you pumped? It's Friday the 13th. [00:07:31][1.7]
Doug: [00:07:32] I didn't even put that together. It's my daughter's birthday too. So it's Friday the 13th on her seventh birthday. [00:07:38][5.5]
Lindsey: [00:07:39] Oh, that is really cool. I was going to say, are we energized? We're just going to die right into content because I feel like you got a ton for us today. OK, we align a lot on this and I'm going to let you just dove into it and I'll shhh. But the whole like diving into our clients or our patients big “Why” as they are walking in and seeing us in the first place? And I feel like one of your questions for them is like, what would you do if your pain wasn't there? So can you go into how you approach your clients? [00:08:08][29.5]
Doug: [00:08:09] Yeah, absolutely. So we work with an active population. And so sometimes, you know, people see that we have a lot of elite athletes and things in our marketing materials. And they say, well, what about just the common person with back pain or, you know, a grandma who wants to be able to play with her kids without pain? And I say, absolutely. But the key differentiator there is we're not focused on getting rid of the symptoms. We're focused on returning to the activity that they want to achieve. And so the reason why that's so important is if success is simply getting out of pain, then you are right in the middle and you can slip back into the symptoms. If success is getting you to a healthy, active lifestyle, you go right past the pain that was limiting you, that brought you in and your goals become much larger. So we take people into the positive end of that spectrum of once you have an able body, how are you going to incorporate that into further enjoyments, more activity, setting new goals, doing things that you never thought possible, and that takes people right past the pain that initially brought them? [00:09:17][67.3]
Lindsey: [00:09:17] Oh, that's fabulous. I love that! Were you seeing that a lot of people were limiting themselves because of where they initially were setting their own goals? [00:09:27][9.4]
Doug: [00:09:28] Well, yes. In my background, I worked with spinal injury patients and in particular in workers comp for a long time. And the goal was for a lot of these people, they were deemed permanent disability. So the goal became pain management. Right. And if your only goal is managing pain, then it's always a spectrum of pain. Right. And especially when people are put on disability, there's almost an expectation to validate their disability. And it's like, OK, you might not be able to work and lift over fifty pounds like you used to, but what's what is the new goal? What does new success look like?. And, you know, the idea of being in constant pain even that is a big misconception because it's not the way that our bodies work physiologically. Pain is an impulse and there's more space between the impulse than the actual impulse itself. So people concentrate on the impulse of where they're experiencing payments. There're actually more moments of not pain than there are of pain. And so even getting people to just focus on the skill of noticing the moments where they don't hurt, right, in breaking the misconception that they're in constant pain starts to form these little successes that you can build on. That's a lot of where we have been able to kind of guide people into using the opportunities when they do feel good to accomplish something. Right. Instead of just saying I'm not going to try because of the fear of pain. Right. And so that's that's kind of where that started. But, you know, as I work with more and more of an active population, I'm a bit of an enabler because I love Triumph. Right. So, you know, when somebody comes to me and they say, oh, you know, I've got this marathon coming up with my foot really hurts. My doctor told me I've got to rest it and everything else. Well, you know, let's see if we can get you through the race. You know, if it's self limiting and you're not going to do lasting damage. Let's see if we can find a workaround and let you beat this. And most of the time, people will train through stuff and it doesn't even bother them on race day. Those are the kind of moments that really get me fired up. It is kind of, you know, getting the mind to a place where we can kind of work with and come out on top of some of those limitations that the body presents. [00:11:57][91.0]
Lindsey: [00:11:58] Right. OK, let's rewind for a second so our listeners can have the same vision I'm getting. Give us your office environment. Give us what you have created. Your kind of perfect dream scenario job is what I think you're living in right now that you can tell us what you think. [00:12:12][14.0]
Doug: [00:12:13] Well, I wouldn't disagree with you for a second. I mean, so, you know, we're in a clinical practice. We're in a clinical environment. We call our practice structural elements. And we are an orthopedic wellness clinic. Now, those two words put back to back are a little bit of an oxymoron. Most people, when they hear orthopedic, they think surgery, they think joint replacement. They think, you know, pain and fixing something that's broken. But when you tie that in with wellness, it's really about prevention of injury, joint preservation, making sure that the body has longevity and that we, you know, get it functioning at optimum. Structural Elements sounds a bit like an engineering firm. And a lot of people say you guys are architects, engineers. And I wear that like a badge because that's exactly how we see ourselves. We see ourselves as body engineers. And one of the things that I point out is, you know, in an engineer's job is to go and evaluate a bridge and make sure that that bridge is safe for cars to drive over that bridge before you let cars drive over that bridge. You don't want to wait until cars end up in the ocean to say, oh, we should have sent somebody in to take that bridge. Right. Why do we wait until we're injured to have our bodies evaluated for mechanical compromise? If we go to a body engineer, if we go to a structural elements practitioner, we can find where there's mechanical compromise or weakness ahead of deterioration of the joint, head of an injury and in the spirit of improving athletic performance. Right. So a lot of what we do is, is quantify mechanical stress and look for those opportunities. Now, you know, we have three clinics, two in Maryland and one in Wisconsin. Right now we are a franchise. I started the franchise and this all came out of being an education company and wanting to figure out how to build long term relationships with therapists, where we could mentor their growth over time instead of just having them come in for a weekend workshop and then call it good. We really wanted to create a network of providers where we have a kind of a platform of best practice that we can continue to learn from each other and grow as providers. So we have a very modern clinic. It's very professional, but it's also, you know, sliding glass doors and, you know, everything's real clean lines. But once you get in the treatment room, it's very soft light. You know, most of our patients, you know, if not fall asleep, get very relaxed during treatment, you know, it's all part of the therapeutic experience. So it's in our practice, we have multiple different disciplines, meaning that we have chiropractors, physical therapists, acupuncturists, massage therapists, but everybody practices structural elements. Even if we have different tools in our scope of practice, we're all looking at the body through a similar lens and that's looking at the body as a whole, as one functioning unit instead of just a series of parts are injuries. Right. And that's a big differentiator. [00:15:26][94.1]
Lindsey: [00:15:27] So if somebody came into you going, hey, my knees are a mess, you might start with looking from their neck to their hips to their.... [00:15:38][10.6]
Doug: [00:15:38] We are going to, not Might, We will. We're going to look at the body from the ground up and we're going to look at the body from their head down and because the knee is a staple joint. And if you're introducing abnormal torque on the knee, it's coming from above or below. Right. You try to initiate a movement from your knee. You can't do it right. You have to initiate it from above or below. So knee pain is going to be the symptom of an imbalance, either in the hips or in the hind foot of the lower leg. So we try to understand where that pain is coming from, not just what tissue is inflamed or irritated. Because oftentimes you can't do that much to the inflamed tissue to make a difference. But you can offload it by correcting the rotation in the pelvis and it gets better, much faster. [00:16:26][34.8]
Lindsey: [00:16:27] OK, case study for you. And this is a little unfair because I'm not sliding a file in front of you and can't see all of it, but what do you do to the client who comes in and they've had even multiple surgeries and they're still in pain. How do you provide some hope for that person? [00:16:40][12.7]
Doug: [00:16:40] Absolutely. Well, obviously, it depends on, you know, the extent of the surgery. What's for the anatomical limitation? Is there a prosthetic joint in all of all of that? Those variables come into play, but big picture posture. OK, let's start there. Big picture posture, because most people have a significant inefficiency in how they use their body because they're using their big muscles, their prime movers as postural stabilizers, which is highly inefficient. And when you're using your big muscles as postural stabilizers, you're going to see numerous compensation's start to occur in changes in the connective tissue itself. So if somebody has said, let's just take lumbar stabilization surgery, they've had a cage put in and they've had a fusion in their lower back. In order to not load the Lower back, you have to balance the center of mass effectively. And if their heads forward and their shoulders are for guess what's putting the brakes on the low back, the injured area, OK? And they're going to fall flat on their face unless they turn their feet out and widen their base of support and squeeze their butt back underneath. That ties up the glutes, the ties of the quads. They're working too hard just to stay upright. And that is just a gross inefficiency. So if we can just get their head back, open their shoulders up and get their center of mass balance, it’s going to take pressure off the low back. So that's what we start with everybody is big picture posture. I'm a nerd when it comes to this stuff. So full fledged, full fledged connective tissue biomechanics geek. But here's the thing that I love about that is that every single body has their optimal position. That is not the same for everybody. But within that system, there's a balance point. And I don't know if you're a musical person, you're going to call me out on this right away. But in piano tuning, there's a term called Mean Tone, which is perfect mathematical harmonics. Sounds horrible, one hundred percent of the time. OK, the reason being is that it doesn't take into account distortion in the room. It doesn't take into account the hydration of the wood. It doesn't take into account the stretch on strings, things like that. So a piano tuner has the tune to temperament, which is fine tune where those resonating levels are. That actually makes it sound good, not perfect math. And so as a practitioner, if we get focused on perfect symmetry, we're doing harm to a patient. That's our vision for the patient versus the patient's body's efficiency. So if we tune to temperament, it's all about finding that sweet spot where that person can find that still point with it that is still good.
Lindsey: Thank you. That was a beautiful analogy and I can visualize it all. Yes. And I think that we can carry that over into everything, whether that's somebody's food intake, their fitness. It all has to be so personalized. [00:19:56][16.1]
Doug: [00:19:57] Yeah, absolutely. Bio-individuality is the big term there? Right. This is what works for one doesn't necessarily work for another. And I'm sure, you know, you bump into that with with diet, you know, it's like one person might thrive on a raw food diet and they promote that to everybody and somebody else, you know, they're going to spend their whole day, you know, consuming to ply.
Lindsey: (laughs) They're going to run into that Bergwall every time. [00:20:24][26.6]
Doug: [00:20:24] Yeah, every time. Right. Yeah. It's all about what that individual needs given their constitution, what sort of activities they're trying to do in their day and ultimately their level of health. Right. I mean, somebody that's really stiff needs something different than somebody that's really active and robust, you know, so it doesn't happen to be the same thing for each person. [00:20:46][21.9]
Lindsey: [00:20:47] So I have to just throw this out here really fast, because a lot of my clientele as moms, grandmas even and I know that you speak athlete often, but I also know that that is not your whole clientele. You too work with a whole population. I just need you to go into your fight for everyone, even the non athlete. [00:21:09][21.6]
Doug: [00:21:10] Absolutely. So I believe that everybody's an athlete. So let's just start with that because everybody's an athlete and whether they are an active athlete or whether they are a dormant athlete, everybody has an athlete within. And they may not have found their sport. They may not have found their craft. But everybody has something that they can do that is athletic and even competitive if they're competing against the right company. Right. So to start with that. But, you know, I work like the other day I worked on a baby. Right. And I absolutely love the opportunity. Their systems are so basic and all they can do is flex and extend. And she wasn't able to flex or extend because she had a couple of stuck vertebrae and a little too much tension on one of her cranial bones that we had a kind of free up. And she immediately changed. And that was awesome. But here's the thing is I also work on, you know, 80 and 90 year olds. And sometimes they have something that's just, you know, creating a gross imbalance, like a rotation in their pelvis, that it's putting them off kilter and they're relying on, and again I use that term prime movers, they're relying on their prime movers fighting like heck to just stay upright. And you correct a major imbalance with a leg pull or something like that. And you give them a balance point where they're prime movers are now freed up to move. And it's amazing a population that struggles with mobility already. You make that easier for them. And it's a night and day change. Sometimes the super fit, competitive cross fit athlete or something like that, that's where, you know, it's a matter of fine tuning. But you can't make these night and day changes because they're not broken. So sometimes what's the most fun is restoring a major function to somebody who is hugely dysfunctional. And that's where you have people that just think you're a miracle worker. Miracle worker? If you took your car into the mechanic and they're like, “I think your problem is this large nail sticking out of your tire” and then they think that you're a magician. That's probably what was causing my problem. But, you know, sometimes when we have these glaring issues of a structural imbalance, that's not the way our medical system looks at the body. So it's just completely missed. You know, they just keep putting air in the tire, but they don't look at the big nail sticking out of the sidewalk. And once you see it, you can't unsee it, you know. But if you're not looking for it, you know, if all you're doing is measuring the air pressure, you just keep thinking we'll put more and put more air and it never resolves. So we work with everybody. And again, some of the greatest moments of loving what I do is taking somebody that didn't see that athlete within them and watching them get out of pain and do something like run fifty miles, you know, and I see that all the time in my practice. Because they start to realize, oh, it's possible. And once they see it's possible, they start going for that goal. But they don't go for it if they don't see it, they don't know what to look for. [00:24:33][139.3]
Lindsey: [00:24:33] Right. So is your belief system that everybody could benefit from walking through your doors? [00:24:38][4.4]
Doug: [00:24:38] Absolutely. Hands down, everybody. Unless, again, I mentioned that I teach a lot and the question always comes up in the class. Have you ever seen somebody in perfect alignment? And my answer is, on some level, this is actually a belief of mine, is that if somebody achieved perfect alignment that they would just, like, disappear into a cloud of steam over, they would just poof be gone. And since I've never seen that happen, I think there's still work to be done. But I did have one time where I came back in the room and there was a gown and needles. And I was like, oh, my goodness, what happened? I thought maybe. But then I realized that I think my patient was supplementing her pain meds with a little extracurricular and she got confused. And let her relieve herself from the treatment. But nobody's ever done OK. And we never discharge a patient. Yeah, right. We increase the duration of time between visits. But we call maintenance mode, right? You're never done working out. You don't go to a personal trainer or the personal trainer goes, well, you're as fit as you're going to get, you know. So Good luck. Well, you start adding more weight, you start getting faster, you start doing more. So with our patients, the more that we chip away the layers. Right. It's like we keep getting them faster, healthier, more relaxed, you know, greater sense of peace, and improved longevity. You're never done with that, right? We're all going north on a southbound train, but you can slow that train down. And that's our goal for everybody. [00:26:17][54.0]
Lindsey: [00:26:18] Yes. Which is so good. And you’re speaking the same language. I actually just interviewed a chiropractor the other week and you're spot on, which is going to bring me into the next topic of your both mostly cash pay because it benefits again, go into that and why that gives you more overall whole body view of the patient. [00:26:36][17.4]
Doug: [00:26:36] Yeah, I'm all cash pay and I've been all cash pay for a long time. I've been practicing for twenty seven years and with the exception of the the dark chapter of working with work comp, not because I didn't love the patients, but because of the limitations based on the insurance reimbursement. When you're accepting cash for services and when you say cash pay, people think that they have to bring a hundred dollar bill. I mean, we still take credit cards, we still accept checks, cash pay means that it's a direct payment from the patient versus a third party billing to an insurance company. But the reason that we do that is we're in a contract with our patients. Our patients are paying us to give them our best advice and to put our best foot forward to get them well during that visit. Right. And unfortunately, when your contract is with the insurance company, you are going to have every good practitioner fall into these traps, you are going to look at how many visits are they approved for? And guess what? They're going to get that many visits. You're going to look at what modalities does the insurance company actually pay for? And you're going to use those modalities. And the diagnosis and reimbursement is going to be based on a body part. So you talked about the knee pain earlier, right? If somebody comes in with a diagnosis of knee pain, guess where I have to treat? Their knees. And I've already told you the big picture posture is one of the most important things. So if I'm giving them exercises for their shoulders and helping them with head forward posture and I'm really working on the neck to change their balance point to alleviate pressure in the knee, guess who's not getting paid, right? So it's just ridiculous that same patient would have to go and get another script to come back for me to work on that other body part. And I have to do it in a separate visit. [00:28:30][86.5]
Lindsey: [00:28:31] And it's enough of a barrier for people to not come back because it's already hard to get through the door sometimes in the first place. So now you're saying go get a new script, come back and there's just enough time in between that we lose them. [00:28:41][10.4]
Doug: [00:28:42] Yeah, and so that's the high road there of best access to quality care. But here's something that I like to point out is it's also the more economical option. And people don't think, oh, “what do you charge?”, two sixty five for a new visit that's so expensive and one fifteen for a follow up. Well, I don't think I can afford that. How much is your time worth if you're going to therapy three times a week for really subpar care? OK, how much is your time worth driving to and from that visit? And guess what? You probably also have a copay, right? Right. And how many visits is it going to take you to get relief? Right. So when you start looking at all of that, you know, we're an extremely economical option. Right. And once people kind of do the math and the amount of dollars, an amount of time spent feeling better, it's a lot of bang for the buck. [00:29:38][55.7]
Lindsey: [00:29:39] Absolutely. And it's one of those. I wish you could just prove it first, you know, because it only takes that couple visits for people to already start to feel so much better. And it's preemptive care. Right. It's so they're saving themselves from so much care down the road, which is amazing. [00:29:54][15.0]
Doug: [00:29:54] And the other thing, too, is the knee pain that is keeping somebody from functioning is what oftentimes gets them into the therapy. Right. But they also have a shoulder that bugs them and they also have a toe that's sore and they also have a little low back pain. Right. Maybe those aren't separate. Right. Maybe that's all related to one imbalance that is challenging the body in several areas. And instead of looking at the body as a series of injured parts, if we look at a person as having one issue and that one issue is an inefficient structure, well, let's fix the structure. Let’s balance the body and then let's retrain the body how to move. So that all of those parts benefit. You will spend your life in therapy if you're doing it part by part. [00:30:44][49.8]
Lindsey: [00:30:45] Absolutely, yes. And wouldn't it be better to spend our life in therapy because we're just cutting that maintenance back to maintenance versus like trying to keep fixing? Can you talk about plantar fasciitis for us for a second? Because I have so many clients who really struggle with that. [00:31:02][16.6]
Doug: [00:31:03] Yeah. Well, you mentioned the demographic that you work with. As you know, a lot of women and plantar fasciitis is more common in women and it is more common in postmenopausal women as well. Or the blood supply to the feet is poor to begin with. It gets extremely poor as we get into later stages of life, and especially after menopause and a hormonal shift, there tends to be a lot of inflammation and poor recovery time in the fascia, which, you know, plantar fasciitis is the fascia, the connective tissue on the bottom of the foot. It dries out. There's one of the biggest complaints with postmenopausal women is is dryness that they see throughout the body. But the plantar fascia is an extreme example of that. Once tissue loses what's called Viscoelasticity, which is its ability to stretch and return back to its initial form, you're much more susceptible to small tears in that fascia because of the loss of elasticity. Once those tears form, then they repair and then they tear again, and then they repair and then they tear again. And over time that leads to larger tearing. And especially in the morning, once you've been at rest, the tissue heals up and then it tears loose those first few steps out of bed, which is why it's so uncomfortable in the morning. The other thing that causes the tearing to begin with is walking across the foot. OK, a lot of women have what's called late stage pronation, which in the formation of a bunion and oftentimes you will see that combination of late stage pronation or Bunion formation with a patient with plantar fasciitis. And the correlation there is as the foot is rolling over that toe, you're instead of going heel toe, you're coming across that plantar fascia and loading it from the side. So some of those bunions are congenital. There's nothing that they did wrong. They just form. But for a lot of women, it's also from history of wearing high heels, shoes or pointy toed shoes that squeeze those toes and don't allow for the foot to properly spread. You don't see many men wearing, you know, jamming their foot into a high heel or pointy toed shoe. I'm not saying they're not out there, but that is also one of the reasons why women tend to experience plantar fasciitis more than men is because of the type of footwear that, you know, is thought to be OK.
Lindsey: [00:33:43] So for hopeful talk again for our listeners here, like, what are your consistent recommendations? Is it get the foam wedge? When should they be stretching every day? Should they be what if they're getting no reprieve from some of the normal recommendations? [00:33:58][14.5]
Doug: [00:34:00] So, again, big picture posture. OK, so there's one exercise that we give to just about every patient, with very few exceptions. And it's laying flat on your back with your knees bent so that your feet are flat on the floor. OK, you tuck your chin so that the back of your neck is nice and long. You try to do a single pelvic tilt so that you're flattening your low back on the floor as well. Your palms go face up, arms out to about forty five degrees to your sides, and you lay there for three minutes and you perform deep abdominal breaths where as you inhale, you push your abdomen towards the ceiling and make sure that you're getting good diaphragmatic movement. Most people don't understand the true anatomy of the diaphragm and how unbelievably important it is to have proper movement of the diaphragm. The diaphragm connects right to where the hip flexors connect. Hip flexors, as I'm sure you've heard of, is a chronically shortened muscle in a lot of people from the amount of sitting that we do and it directly affects the ability for the diaphragm to properly move. So if they lay flat on their back for three minutes a day and do that deep belly breathing, it's going to free up the diaphragm for proper movement. Now, that's important for big picture posture so that you can achieve uprightness. But there's another huge part of this. And that huge part of it is our stress response is regulated by something called the autonomic nervous system. So sympathetic is our fight or flight. Right. And our parasympathetic is our rest and digest. The sympathetic nervous system turns on with tension in the mid thoracic spine. So we're looking at screens when we're sitting at desks, when we're driving in cars, we're stimulating our stress response constantly. OK, the off switch to that is the parasympathetic. If you've heard of cranial sacral therapy, part of the reason that that's important is that the parasympathetic is located in the base of the cranium and in the sacrum. So our rest digest, our off switch, which requires that we have good articulation of the high neck and proper mobility of the SI Joint. And so it's not just important from wearing your knees out. It's also important to properly digest, to regulate your blood pressure, to regulate your heart rate, to be able to properly oxygenate tissue, to have good circulation go up to the extremities, to repair that plantar fascia. It's dependent on being able to get into a parasympathetic state where we're actually resting and digesting and repairing. If we're always in a sympathetic state. We have all the isms, right? We have the syndromes, we have fibromyalgia, we have chronic fatigue, we have the IBS. We have many of the metabolic disorders that we're seeing in people because they're constantly taxing their adrenals. But being in an on sympathetic state all the time until they crash and get through fatigue. Right. But we can turn that off once a day. We can lay flat on our back and we can switch from sympathetic to parasympathetic and get into that restorative mode. But it costs nothing. That takes three minutes a day. [00:37:11][141.3]
Lindsey: [00:37:12] Wow. Three minutes a day. Shove it in between two other habits, right? [00:37:15][3.4]
Doug: [00:37:16] Exactly right. And for you and for the overachievers out there, do it twice a day. Don’t do it for a half hour, OK, do it three times a day. But keep it to the three minutes. [00:37:27][10.8]
Lindsey: [00:37:28] OK, I like it. Gosh, everything just keeps coming back to if we don't slow down a little bit as a society, if we don't take a recognition of what our body is screaming at us, that at some point it affects everything like food sensitivities. I think you could go into that. [00:37:49][21.1]
Doug: [00:37:50] I say one hundred percent. Yeah, it's all tied together. [00:37:52][2.0]
Lindsey: [00:37:53] I would love to hear. Have you seen a fibromyalgia patient go from really struggling to more maintenance mode? [00:38:00][6.3]
Doug: [00:38:00] Absolutely. So when you take the term fibromyalgia and break it down, fibro means fibrous and myalgia means muscle pain. OK, so all fibromyalgia means. Now fibromyalgia syndrome, is the secondary effect that this has on digestion and depression. But wouldn't you be depressed and wouldn't your body struggle to properly digest if and and sleep and all of these things if your body was in pain all the time? Of course, But the fibrous changes that happen that cause muscle pain are from the posture. They're from the change of not having good visceral elasticity. And tell you the truth, a huge part of it is from the low fat, when everything went fat free and fat became bad. We stopped doing fat free everything and people stopped getting healthy fats in their diet. Fat became the enemy. Our body needs fat to keep our tissues supple and to keep our tissues lubricated. And when we went through a huge “diet everything” and fat free everything and people stopped eating real food with good sources of fat. You saw a huge spike in fibromyalgia because tissue became more fibrous and more inflamed. [00:39:26][63.4]
Lindsey: [00:39:27] Gosh, so interesting. Yes, so I just feel like for our listeners out there, like if you are feeling hopeless, or if you’re feeling like you're continuing to hit that brick wall, you do appointments virtually. Right. Like you could even help somebody at least get a conversation started to know if they even live near you. How does that look? [00:39:47][19.8]
Doug: [00:39:48] I mean, so through our website is a structuralelements.com and we do what we call telewellness, which is basically and again, a lot of it is simple exercises that you can be shown in a matter of minutes. Right. The one challenge we have virtually is, you know, it's hard to correct some of the skeletal imbalances that do require some information. And we also do use needles in our practice. We use acupuncture/ dry needling. And it's the same thing, if we have to talk about that. But that's a little tougher to do on screen. Right. But we can still help people locate where some of those key trigger points are, where you have multiple layers of muscle that are moving in different directions that are kind of the key spots for self myofascial release or pin and strip methods of taking a therapy ball or even your fingers and then taking that joint through a full range motion to separate those fibers and restore function. The other thing is when a lot of people are left on their own, they're going to beat up what hurts. Right. So their shoulders hurt, so they sit there and have somebody dig an elbow into it and they keep beating it up. Well your shoulder is screaming for help because you have too much demand on it. Don't beat it up and then subject it to the demand, right? Sit up tall, take the shoulders back, take pressure off of that area that's screaming. So sometimes it's just guiding people to the right spots and they're able to be much more effective, even with the practitioners that they're working with or or in their yoga practice or with their self massage tools at home or things like that. So we can help problem solve. [00:41:28][20.8]
Lindsey: [00:41:29] So, yeah, and you're such a team approach that you could be part of the team and help guide them to a physical location so that they have you as well as their physical dry needling what not, going on as well [00:41:38][9.2]
Doug: [00:41:38] Even better if I can do a shameless plug. We offer the opportunity for any provider who's licensed in their state to become a (se) network provider. And that is not a franchise. Right. That just is the ability to learn the structural elements methodology and then continue to be mentored through our community platform, which has all the business resources, social media, and patient acquisition strategies. But more importantly, it's looking at the body through the (se) lens. Now, that's different than working in one of our clinics where you have to be a micro franchisee or to own one of our clinics where you're actually a clinic owner and the clinic franchise. But anybody who's a chiropractor or massage therapist, physical therapist, anybody is eligible as long as they have a valid license in their state to become an (se) network provider. So we can even take somebody who says, “I love my physical therapist. I think they are so good at what they do. They care so much, but they don't really do exactly what you're saying. I would love to introduce them to structural elements that they could learn how to do this. You know as well, you know, we're all about the educational plan. [00:42:48][16.5]
Lindsey: [00:42:49] That's awesome. So much content and resources out there that you've already done all the legwork on. [00:42:55][6.2]
Doug: [00:42:56] Oh, we've done the heavy lifting, you know. Yes, that's the cheat sheet. It's the cliff notes, the roadmap, so you don't have to do ten years of study and twenty seven years of practice to find some of these clinical pearls. [00:43:07][11.2]
Lindsey: [00:43:08] Oh, right. Oh, my. And can you see, I've noticed even just through interviews, like concierge therapists, like I am seeing this flow of we're going to keep seeing more and more holistic body approach type care. Are you seeing that on your end? [00:43:24][16.0]
Doug: [00:43:25] One hundred percent. There is both a push and pull that's happening. The push is the insurance world is becoming almost intolerable because of all of the paperwork in the documentation and the billing and doing all the administrative work to get paid for services that you've already rendered. Right. So that's the push - pushing a lot of people out of that system. And the time constraints of patient visits because you have to play the volume game because of negotiated rates. That's pushing a lot of practitioners out. The pull is that the lifestyle that you can set your own schedule, the ability to not feel so rushed, but to actually get to know your patients, maybe share a laugh or two and you know, and really feel like you're a part of their healing, not just being a traffic director to give them that the next step down the line. So a lot of people want to know their patients. Here's the other thing is we get to know our patients when they're well and when they're not well, we can usually recognize where they've deviated from their norm. If all you do is stick care, you have no idea what that person looks like in a healthy state. Right. So for us, it's relationships. It's getting to know people and patterns. Right. And that's a lifelong thing. You know, it's like we would say that we might not see somebody for a while. But I guarantee you, the moment that they start having problems, our phone is the one that's going to ring. If you have that trust.
Lindsey: Yeah. And from this side, like, if I get sick, I want that person who does know me and I already feel so comfortable and it's an easy get right in the door versus again, like I see with a lot of my clients, there's a lot of barriers because I think we get sick of you can get appointmented out, you know, like I've already been to that person. I've already been to ortho, I've been to physical therapy. Well, maybe I haven't been to the right ones yet. Like, keep trying. [00:45:27][28.7]
[00:45:28] Yeah. And that movement towards cash practice, I mean, you know, again, it's also an economic thing for patients as well. I've kind of talked about it from the practitioners standpoint, but from the patient standpoint, people are fed up with having to jump through all the hoops and do the dance. They just want to get right into somebody that can start making a difference today. And I have zero pushback from patients about having to pay for that luxury. They'll ask me for a recommendation of where they should go for their physical therapy. Right. But they come to me and they get treated and they see it as a different thing. Right. If you had surgery on your shoulder, go to physical therapy and have that rehab done. That's what they do. That's what they're set up to do. We do no post surgical rehab. And for us, it's all about body balancing and whole body solutions. Right. It's not just about rehab and one joint. There are people that do that and they do that really well. Right. [00:46:32][26.4]
Lindsey: [00:46:33] It's kind of like doctors in their specialties in general, like go to a specialist if you have a problem, because that's what they live in that world every day. [00:46:40][7.0]
Doug: [00:46:41] Absolutely. We are orthopedic generalists. Yeah. One hundred percent. What we are. [00:46:46][5.4]
Lindsey: [00:46:48] It's good. OK, I know you're working today, so I'm working towards wrapping this up, but I know that you have children, how many kiddos you have? You have talked about your daughter. [00:46:55][7.7]
Doug: [00:46:56] I have too little girls, a four year old and a seven year old. [00:46:58][2.5]
Lindsey: [00:46:59] OK, so the way I kind of want to wrap this up is I like to see as a parent, you know, your wish, your want for your kids, because I think that, like, if we know how you view their bodies and like what would be your end goal by the time you send them off to college, what do you want to make sure they understand from everything you're practicing as you send them out into the world? [00:47:22][23.3]
Doug: [00:47:23] Yeah. So there's two things that I would say are kind of fundamental goals for my kids in particular, but would be for anybody's kids. This isn't exclusive to mine. I work with them to build the athlete, not make them better at their sport. And so the difference is you have a lot of people that are good at the sport, but they lack fundamental functional movement which put them at risk of injury, or they get too specified in a sport and they start to develop imbalances that put them at risk of playing other sports or at risk of injury. So for my girls, I work with developing a functional athlete and having them be healthy in their bodies versus just good at a sport. The other thing is to make them self aware. My girls can come up and tell me when they need an adjustment. They'll be out playing like any other kids, you know, and they'll bounce out of the bouncy house and they'll come in crying. The only difference is my daughter will say, Dad, “I hurt my SI Joint” and I think I need an adjustment. Or she'll be doing cartwheels and she says, Dad “my wrist is subluxed I need to adjust my carpal bone”. And she’ll come in and she'll be right. You know, they'll be out of alignment. But she has that awareness of when something hurts, she can identify it in her body and she can know when she feels unbalanced. Even to the point when she's a little moody or emotional sometimes “I don't know what's wrong, maybe I'm just out of alignment”. And oftentimes she is right and she stressed out and doesn't know why. But it has that awareness that there's a connection to the body and that there's a solution. And so that for me is if there's one thing that I feel like I really give to my girls is a gift of being their dad as a bodyworker, is that early awareness of a sense of self, you know? [00:49:19][12.7]
Lindsey: [00:49:19] Oh, it's huge, because I can tell you right now, there's so many adults that don't have it yet. So to gain it as a four and a seven year old and know that they'll only grow into that more and more is absolutely amazing. [00:49:31][12.0]
Doug: [00:49:34] Yeah, I love it. They love spending time at the clinic. They fight over who gets to get on the table first. [00:49:39][5.3]
Lindsey: [00:49:41] That's so good. Oh, thank you so much for your time today. We really appreciate it. Is there any last minute shout outs? My pleasure. Yeah. Any last minute things that we miss? [00:49:51][9.7]
Doug: [00:49:51] Just information. I think we got the important stuff, you know, the rest is in the weeds. But, you know, as far as if anybody wants more information against the structural elements, dotcom is the main face of public facing site that you can find more information. And I'm super available in terms of I mean, I'm a busy guy, but meaning in terms of, you know, Dugit structural Match.com. I mean, if you have a question ReachOut, I mean, I'm all about public education and helping people navigate their situations. So, you know, I'm more than happy to get involved. [00:50:32][38.5]
[00:50:32] And in a conversation, if you've got questions and that's another breath of fresh air hearing that, because it's just hard to feel like we can have a direct connection for some questions. So thank you. Thank you for saying that. Everything will go in the show notes, by the way. And I know you've done other podcasts as well. So if there's any other podcast that you feel like you kind of hit on different topics, that we can throw those in the show notes and just. Absolutely. I think both you and I are all about just shouting out content into the world and making sure that people feel educated and empowered. [00:51:08][35.8]
[00:51:09] Empowered. Yes. Yeah. Yeah. [00:51:11][2.1]
[00:51:12] There's a lot there's a lot that you can do that doesn't require the authority of somebody else to get. [00:51:16][4.6]
[00:51:17] Well, yeah. Oh, that's good. Say that again. [00:51:20][2.9]
[00:51:21] There's a lot that you can do that doesn't require the authority of somebody else to get. [00:51:26][4.4]
[00:51:26] Well, yeah. Because I think there's so many times that I keep talking barriers today, but people get stagnated because they feel like they don't have the power to move forward. It's just hopeless. And so putting the power back in their hands. Yeah. Yeah. Well, thank you. Be safe on this Friday the 13th. [00:51:46][20.0]
[00:51:48] Go do some birthday to. Thank you. All right. Have a good day. Sounds good. Awesome. Thank you too. [00:51:54][5.9]
[00:51:55] Thank you for joining me today at this topic. Served any purpose for you or you could picture that exact person who needed this. I'm always honored when you share the episode. We are making 2020, the year that we are going to pour motivation and inspiration on to others. I also always appreciate when you leave reviews on iTunes and great for podcast, I send you off with all the praise and momentum you deserve for staying open to new information, keeping an open mind to the fact that our journey will look different now. A year from now, five years from now, slow and steady. It's not always instant gratification and it's not always that exciting, but a much gentler reteaming path that will serve you well throughout all of the years and every season of life. I cannot wait to catch up next Friday. Cheers to health and happiness. [00:52:44][48.5]
[00:53:01] Before you go, I am thrilled to announce that our direction, not perfection community, is going to have its very own membership. We have officially named this the powerhouse membership, and in this house, we thrive, not just survive in this house, we lift each other up. And in this house, we offer permission to keep your eyes on your own paper and follow your own path to health and happiness. Our doors are going to officially and virtually open January 1st of 2021. However, we are accepting early enrollment for our founding members and they are going to lock in at a rock bottom price of twenty five dollars a month. And then once the doors officially open in January, it will go up to fifty nine ninety nine. I'm going to be leaning into these founding members to help build this membership into exactly what we all need it to be. So a quick little glimpse of what will be offered. There will be a monthly meal plan to just jump start your ideas and feel refreshed with your food choices. You'll get that at the beginning of every month. We'll also kick off the month with an accountability group. It's one week where we all set our own personal goals and hold each other's feet to the fire. Tons of fun. It's a fabulous momentum builder and it just propels you right into the rest of the month feeling like you've planned for it and you're ready to take it on. Then we will also have weekly touch points with zoom calls or Facebook lives. And lastly, we'll have personalized motivational text with recipe ideas, quotes and just other ways to cheer you on. And again, we will be building together, but that is currently the game plan. And if you have any interest, please reach out to me at Health Accountability Coach dot com. I will have that in the show notes for you. I've actually been toying around with kind of a fun way to do a reward system within our membership, kind of thinking along the Chucky Cheese reward. You know, when you walk up to the checkout counter and you stare at all the prizes and you can see exactly how many tokens it's going to take in order to get that prize, what you're going to have to work up to. Well, I was thinking it could be pretty darn fun to have that same type of thing for our powerhouse membership, that when you reach a goal, you get a certain amount of points. When you complete a course, you get a certain amount of points. When you show up to a zoom, call certain amount of points. And when you reach certain levels of points, there will be prizes offered. Anything as simple and as lower points would be something like a powerhouse water bottle all the way up to a free hour long consultation with myself or another dietician. I know I do better when I know I'm striving for something. So a little reward system has been burning on my brain. I'd love to hear some people's thoughts around that. OK, I've rambled on long enough in this Friday. Have a wonderful weekend, fabulous Fridays and cheers to health and happiness. [00:53:01][0.0]
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