Learn How to Manage Pain: Recovery Tips From a Top Physiotherapist
5 Feb 2025 · 47 min
In this episode of the Beyond Diagnosis podcast, host Rita De Michele interviews physiotherapist, strength coach and AMT founder Tom Swales. They discuss why focusing solely on pain is insufficient and why practitioners must assess the whole body and the patient’s psychology before treating a specific area. Tom introduces a five‑principle framework—psychology, neurology, biology, chemistry, physics—that underpins his approach to injury recovery and pain management. He explains how the nervous system’s perception of safety, trust, and fear shapes pain, and how simple daily movements (joint circles, spinal waves, isometric holds) can re‑educate proprioception and calm the nervous system. The conversation covers the dangers of self‑prescribed exercise, the importance of using pain as a guide rather than a fear‑driving signal, and the need for consistency in daily mobility work. Tom shares his personal story of surviving a life‑threatening streptococcal infection, illustrating the role of lifelong resilience, strength, and nutrition in recovery. He outlines a holistic assessment strategy for post‑surgery patients, emphasizing symmetry, compensations, and the integration of movement across the whole kinetic chain. The episode also offers practical advice on selecting a practitioner—prioritizing psychological connection, clear education, and measurable outcomes—and a simple floor‑sitting mobility routine to improve flexibility and fall‑prevention. Throughout, the dialogue is conversational, supportive, and enthusiastic, aiming to empower listeners to take control of their health through informed, whole‑body movement practices.
Chapters
If a practitioner is just chasing and focusing on pain, you need to get a new practitioner because they should be looking at everything around that pain first before they zero in on that area.
Yeah, it just sounds so incredibly intricate. And in saying that, what, what would be the dangers around, um, a self-prescribed exercise routine? Like you're in pain, you want to stretch out, maybe you don't really know what you're doing. What are the dangers around that?
So I think the dangers would be pushing past pain or pushing into pain. You know, there's going to be ranges of motion that, you know, if you haven't moved there in a while, it's going to feel uncomfortable.
Hello and welcome to Beyond Diagnosis, a podcast to raise your awareness, decisions, and voice for alternative practices so you can take back control of your health. I'm Rita De Michele, Your host, a mindset and empowerment coach, and the founder of the Onus platform. Join me each week so you can create the health of your dreams. If injury, pain, stiffness, or any other type of physical concern stops you from living the life that you want, then stay with us because today you'll be getting the solutions you've been seeking. I'm absolutely thrilled to have Tom Swales on the show. As a physiotherapist, strength coach, and founder of the AMT certification, Tom has dedicated his career to helping people move better, feel stronger. His journey has been shaped by a life-threatening health challenge and has instilled resilience and passion in his work. Today, Tom will dive into things like recovery, resilience, overcoming pain, movement. So stay tuned, we've got a great show coming. Welcome, Tom.
Hi, Rita. Thanks for having me.
Oh, you're so welcome. This is going to be really good, especially for people that get up in the morning, they're stiff, they don't know what to do, or they've got an injury, they've had an operation. I can vouch for my sister who had ankle reconstruction. She's in pain all the time. You know, it hasn't really been assisted. So, you know, let's go down this path and start with the importance of injury, um, correct injury recovery. And you also emphasize mastering the fundamentals of movement. Explain to me in layman's terms what you mean by that.
Yeah, so You know, whether we have a new injury or an old injury, it's it's really coming down to understanding what our limitations are, what we can do, and what we can't do. You know, oftentimes we get these diagnoses, and and a diagnosis is okay. It you know it helps label something. It helps put a name to something. It helps communicate to other professionals what we're talking about. But Really, it helps give us guidelines as to what are the normal healing times. And when something starts to fall outside the normal healing times, but things are still painful and stiff, well, then we have to start figuring out, well, why do I still have pain when the injury is resolved? And oftentimes it's fear, it's a lack of movement into certain ranges, so the nervous system doesn't feel safe or comfortable. So that's going to create signals for discomfort or tightness or pain. And once we get past that mindset of, you know, I have pain, therefore I'm injured or I have trauma, then it becomes a little bit easier for us to move into those discomforts. Because really, at the end of the day, it's, it's more about a discomfort than a pain. And if we can move into those discomforts, we start breathing into those discomforts. All of a sudden, the nervous system starts to realize, oh, you know what, this is actually a safe place to move into. And now all of a sudden, oh, we're moving a little bit easier today. Oh, I can bend a little bit more forward. I can squat a little bit better.
Yeah.
So, when we understand that discomfort and pain are often misdiagnosed or mislabeled as one another, then we can remove that fear. And then once the fear is removed, now we can have that ability to move past it or through it and start to see real progress. And it doesn't take much. We can do something as simple as get on the floor for 5 minutes. You know, we have people doing something as simple as just rocking back and forth, shifting side to side, you know, doing some spinal movements and waves, just joint circles. Something as simple as, you know what, you got a stiff neck, just rotate your head left to right, look up and down, move through those full ranges of motion. Do some joint circles with your shoulders because when we do circles, the brain is really paying attention. There's a part of our brain called the cerebellum. It likes to do circles and all these little spiraling movements. But we're also increasing, improving proprioception or body awareness. And those sensory receptors, those proprioceptors, are going to dampen any of those pain receptors. So now all of a sudden the body starts to relax because it's a little bit more organized, because it feels safer in the ranges of motion that it just perceived.
That's incredible. You know, I wouldn't have really thought of it like that, and I don't think most people would think of it like that around safety. Like, the body has to feel safe Before it allows you to do what you need to do, before it allows you to stretch out or to move the neck or adjustment or anything like that. I would never have thought of it like that. It's amazing. And in your experience, are these fundamentals commonly overlooked in other people's practices? And how can they accelerate your results?
Yeah. So You know, doing this for, you know, 20 years now— athletic therapist, strength coach, you know, physiotherapist— you know, I've taken lots of courses. And everyone, every course, I'm grateful for. It provided me different insights and tools and techniques and solutions to specific problems. But over the time, it became very confusing, and my practice became very disorganized. It was— it felt like a lot of guesswork. So I started just like, well, what am I— what, what flavor of the month am I using this month, right? I go do a course, everybody's getting this this month because this is the new solution.
Hmm.
And then I started to look across all these movement practices and manual therapy practices and acupuncture and all these different techniques, and I started to realize there's, there's a lot of commonalities across them. There's these common principles that they all work on, and these 5 principles, they're 5 older studies you know, what we do as practitioners is relatively new. It's, it's not, you know, maybe a couple hundred years, so to speak, maybe 100 years. But when you look at the body through the lens of psychology, neurology, biology, chemistry, and physics, now we can start to break down what we actually do, why we do it, and how we can do it better.
Hmm.
So for example, the nervous system. So every first interaction, every first relationship starts with a conversation. Patient comes into the office, we're going to sit down, I'm going to ask some questions. They're immediately judging me and be like, do I trust this person? Do I feel safe? Like, whether they're, whether they're doing consciously or unconsciously, most of the time it's unconscious. They're picking up on my body language, my tone of voice, the words I'm using. And if they feel safe, then it's— if I can, if I can communicate effectively, it's going to create that connection. If I get that connection, I get trust. If I get trust, I get safety. So now I've broken down that first barrier of their psychology to now allow me to change how their body feels, change how their nervous system feels. Because if, if I am not good at connecting with my patient, their nervous system will never let me in to make changes on their nervous system and their biology. It just won't. Like, you can be technically super the best clinician in the world, but if they don't like you, They just— you creep them out, they're not coming back. And, you know, they're never— doesn't matter what amazing techniques you do, it won't change. It won't. So this is where the art of, you know, communication is critical because that psychology component is the first component to getting people better, right? They come in with these belief systems. I have degenerative this. Oh, I can't do that. No, no, you can. And now we're going to use neurology and movement to show you what you can and cannot do. Right? So now we, we go into the nervous system because what's the nervous system's primary job? It's survival of the individual, survival of the species. Like, if you distill it down, it's primarily survival. Okay, so how does the nervous system help us survive? Well, it's through the different systems. We have the sympathetic and parasympathetic system. Okay, well, what does that mean? Parasympathetic's your rest, digest, recovery, right? Then you have sympathetic, which is your fight, flight, freeze, and faint. Most people coming in in pain, what, what state are they in? They're in a sympathetic state. They're in that fight or flight. Well, there's no healing that happens in that state. So I have to shift their nervous system to that parasympathetic state so I can create change. And also, we can use neurology and movement when I'm getting into the manual therapy or the acupuncture or the needling or the manipulation, whatever it is. If I apply something to the body, The nervous system's automatically be like, does this feel safe? Yes or no? And if it likes what I do, if it feels safe, it relaxes the system, it organizes. Now all of a sudden muscles turn on, movement improves. Okay, great. That was a feedback for effectiveness. If I apply something it doesn't like, or they have a belief or a bad experience with something, what are they going to do? Nervous system's like, nope, don't like that, had a bad experience, can't crack my neck, can't do that. So this is where specific tools are going to be very individual to the person because of their belief system. So this is why, again, it comes back to psychology and why that's so important. I need to know, do you have a fear with needles? Okay, you do. Great. We're not doing acupuncture because it's not going to shift the nervous system in a direction I want. I'm not going to get the healing that I want. And then when we look at biology, well, that's just, you know, basic fundamentals of development in the fetus all the way into cell biology, into tissues, tissue healing timeframes, adaptation, all that stuff. When we apply modalities to the body, which is an energy, we're affecting the cells. Well, if it's the right dose, it causes physiological biological changes. It improves tissue healing. If it's too much, it will cause damage. If it's not enough, it does nothing, right? So now we have biology because now we can affect the physical being, but the biology will not change if the nervous system is on high alert and if their belief systems are not in the right place. Then, then we move into chemistry. Now chemistry, I was lumping in with biology. And when I went in the hospital, you know, they had me on respirators. And I was getting in debates with the doctors. I'm like, I don't need more oxygen, I need carbon dioxide, because we do breathwork. And we, you know, improve oxygenation through breath holds. And they're like, no, no, you have so little oxygen, you will die with more carbon dioxide. So then I realized, I'm like, oh, because my chemistry is off. it's the wrong context to use this specific technique. So because I had sepsis, my blood was super acidic. I couldn't absorb nutrients. I wasn't transmitting oxygen effectively. So they, you know, they had to put me on all these devices. So I quickly realized, well, nutrition is chemistry because nutrition is information. It's broken down into its molecules and it's what makes all of our tissues. And if nutrition is poor, we create and we repair with poor amino acids or poor quality tissues. Now we, now we've created bad tissues or just weaker tissues. So, you know, everything— our DNA is molecular. It's carbon, hydrogen, nitrogen, oxygen, phosphorus. It's 5, and it's just in various forms. Everything is molecular. So when you start looking at, well, from— we go from biology and cells, you go down to a molecular level and you start to look at the composition of all these cells. Okay, cool. But now we have a better understanding and a framework of how we can explain nutrition and why breathwork is important and why, you know, making sure our pH is right in our guts for digestion, it's not too alkaline, all these things. And then the last one is physics. And we can look at this 2 different ways. We look at physics from a Newtonian perspective. So you have physical matter in the 3-dimensional world, gravity, you know, all the laws of physics. And then we have quantum, and quantum is— you look at it from vibration, frequency, and energy. Okay, well, what does that mean? When you look down at an atom, an atom is 99.999997% empty space. That very, very small percentage is actually physical matter, which means we're that amount of empty space. Well, what creates matter? It's vibration, because we're both vibrating on a frequency that we can perceive in the 3-dimensional realm. Okay, cool. All right, so now we're going down to an atomic level. And if you go even further down to quarks, quarks are waves. It's just wavelengths. And these waves are creating specific frequencies as well. So now we go back up. Okay, well, what's a thought? What's a belief? It's a frequency. What is the— what do those thoughts do? Well, they affect the physical body, either in a positive way or a negative way, which is why the placebo effect is so powerful. Because if I have a belief that I can get better, my body will create the chemicals to get better. If I have a belief that I will never get better, my body will create the stress hormones to make that happen. So now it's all circled back up to psychology and the belief system back from quantum physics. So it comes full circle. But when we understand these 5 principles and we work from those, then it becomes a lot easier to understand what we do, why we do it, and how we can do it better. And then we can build more knowledge on top of that. Because the more knowledge we build, the more confusing it gets. But now we have a framework based on principles to build upon, and now we have a better way to explain what we do.
That is a fantastic explanation, bigger and broader than what I thought when I was gonna ask you about fundamentals. I thought, I thought you were gonna go into the physical, but it makes so much sense. You know, we have— everyone talks about the mind-body connection. And you can't get away from it. You know how our mind affects—
Yeah.
You know, like, for example, if someone came to you, um, and they were fearful of what you were going to do, I mean, how would you get through the muscles that would tighten up like a brick unless you actually do all of this? Which brings me to, if I was someone who came to you and I have just had an operation, or maybe I've had a hip replacement and I'm just not walking properly, Or have chronic pain.
Yep.
How would you start assessing me so I know I'm with the right person, and what would you do for me?
So, you know, even though we change out a part, you know, we, we don't work like a machine. We don't work like a car, you know, changing out a part. You know, they kind of work individually. We are so highly integrated that something as simple as a big toe not being able to extend during gait can cause back and neck issues because it will cause rotations all the way up. So you have a hip replacement, I'm going to treat it and I'm going to assess the same way as I do with everybody else because 10 people can have hip replacements that are done by the same surgeon in the same way, but because that person might have a little bit more pain, a little bit different experience, a different belief about their injury. They're going to create different compensations. They're going to move differently. Pain changes behavior, and movement is behavior. So you're going to have 10 people moving very, very differently and have predisposed maybe restrictions in their other body. So I need to see how their system's moving first. So even if it's a hip replacement, I want to see, can you get your neck Can you bend and rotate your neck effectively and optimally? Yes or no? And do you have pain? Because if you can't rotate your head to the left, well, now you have to turn through the spine more, and now that spine rotation is going to affect hip rotation. So that could be a potential reason why a hip is kind of feeling tight all the time, because, well, you're rotating through the lower back, and the lower back's not designed to rotate. Can you touch your toes? Can you backbend? Can you side bend? Can you rotate? And is it the same? Is it symmetrical? The nervous system really doesn't like asymmetries because if you move differently on one side of the body or the other, and you say you move really well to the left but you don't move to the right, every time you walk, guess what you're doing? You're rotating more to the left. Well, physics tells us energy moves to the area of least resistance. So if it's really easy to move left, you're just going to keep loading into that left side. Now all of a sudden you get a left low back issue. because you have a right hip issue. So, you know, we have to look at how is the system integrating, what parts are moving or which parts are not moving, and then we start to weed through and find out where those main linchpins are of movement restriction or weakness or control issues so that we can kind of unload that new hip and distribute forces across the body. Because we know, okay, well, the hip joint moves like it's It's a mechanical device now. The surgeons put it in, but now the nervous system has to reorganize around it because now we have scar tissue that we have to work through. We have numbness that we have to work through. We've— now the brain has this new component that it has to map in and feel differently now because I've had clients where they're like, I can feel the components. Well, yeah. Have you ever put a watch on for the first time after a year? you notice the watch is there for about the first couple weeks, and then you accommodate because your nervous system learns to ignore it. But because they have this new sensation, new sensations feel threatening, and the nervous system doesn't like that. So it all of a sudden sets off the alarms, and it can start to create pain. Now, it doesn't mean that it's pain in a bad way where it's, you know, causing damage, but it is pain to say, hey, something doesn't feel right, this doesn't feel safe, so I'm going to make you pay attention to this. And now our job is to find out, well, why is that pain on, right? Because I mean, pain is a signal. It's either a signal for change or it's a signal to pay attention. Most of the time, unless you, you know, take a trauma, we have pain. Now you have pain because there's damaged tissue. But if there's no damage, pain is just a signal saying, hey, you need to pay attention to me. Doesn't mean this place is the problem, but you should probably find out why it's here in the first place. And if, you know, they're depending on— we'll go back to the total hip replacement example. Depending on the type of surgery, there's sometimes there's limitations, like depending on the approach. Sometimes you can't bend the hip past 90 degrees for the first 6 weeks because of healing, because of healing tissue. So that pain's okay. You just listen to that. You know, you find it and then you just back off and you move in and out away from pain. Again, pain is telling you, yeah, I'm not really familiar with this spot, or it doesn't feel safe. So you can move, you can come up and touch it, but I always tell patients find it and then just back off from there, but work in the range that you have, right? Do some breathwork, go up into that range, breathe through it, get the nervous system to start coming down, come out of it. All of a sudden you'll start to see, oh, my range of motion is getting better. Well, because you're breathing through it, you're teaching the nervous system not to panic when you hit that range of motion, and it's starting to calm down, starting to reorganize. Now all of a sudden range of motion is improving. So As long as people are using pain as a guide, then it's just appreciate that it's there and it is there to protect you. As long as it's not, you know, um, it's not— you're not catastrophizing it or, you know, paying too much attention to it. Because if they're really focusing on pain, what does our attention do to pain? It increases it. Because where we put our attention is where we put our energy.
Mm-hmm.
So now we're going to amplify those parts of the brain that are mapped into that painful zone, and it's going to make it bigger. So as long as people aren't panicking with it and they, they appreciate, okay, yeah, that's uncomfortable, and they keep working through it, it will get better. Now, if you're plateauing, if all of a sudden, oh, this isn't working anymore, okay, now we need to do something different because there's no point banging your head against the wall hoping for a different outcome by doing the same thing, because that's just insane.
Yeah, absolutely it is. So Tom, what, what would be the importance in your opinion of like daily stretching for muscle pain or, or even for recovery?
Yep, uh, do something every day. I mean, consistency is key regardless of what it is, you know, whether you get on the floor and you do some push-ups or you do some cobras, or you do some yoga, or you just do some rocking and rolling, do some— do something, right? Move through ranges. Even just bending forward 10 times to touch your toes, it will have an effect, and it has an accumulative effect over time. The more consistently you do it, the more the nervous system and the tissues learn, okay, we can do this. And it gets easier and easier the more you do it, because the nervous system is a brake system. If it doesn't like what you do, it turns on the brakes because it wants to protect. If it is familiar with something or it feels safe with something, it takes the brakes off. Well, yeah, no, I'm familiar with this, we can keep doing this, and then you don't lose it. But oftentimes we're not moving through enough ranges of motion, and all of a sudden, oh, my neck is stiff, that means it must be damaged. No. How often do you look up? Many of us don't anymore. We're looking down. So now all of a sudden we have these tight necks, and it could be just muscle weakness, right? You know, if I look up, my neck looks a little bit tight. But if I add a little bit of tension on the back of the neck, all of a sudden, look at my range of motion, it improves, all because I applied some tension back in the neck here. I told my brain, oh no, we have control of this, and it let go.
Actually, for our listeners, on that point, you actually had your hands up behind the back of your head.
Yep. And you lace them looking back.
Yep.
I look up, I feel okay, I feel a pinch in my neck, put my hands on the back of my head with my fingers laced, and I'm pushing my head into my hands for a 5-second count. So we're doing an isometric contraction. And then I release the hands and I find more range of motion. Now when I get that new range, I could do it again. 5 seconds, we get more range of motion. So now it loosened up all the muscles on the front because we simply strengthen the muscles on the back. And oftentimes people aren't tight because of a lack of flexibility. People are tight or they have poor mobility because of a lack of strength. So doing something simple like isometrics, pushing into a wall, push your shoulders into a band, you know, sit up against, do a wall squat, get your quads moving, or get the quads, get your brain to feel those quads. All of a sudden, oh, my back doesn't hurt anymore. My, I can feel my glutes. I can touch my toes simply because we added an input to the system that it liked, aka strength, and it found certain muscles and it reorganized in a specific way. So now all of a sudden movement is now our feedback saying, oh, we did something right because I'm moving and I feel better and my pain's gone.
Yes, I believe you're a big believer in developing that resilience in the body. Tell us a little bit about resilience and why it's important.
So resilience, and I can, I can speak from a personal experience, um, it's your number one insurance policy. You know, people ask, well, what's the point of, you know, being so strong? Well, what if you have to carry your child? What if you have to drag something, somebody, you know, you got to carry somebody? What if, right? You want that extra capacity so that if things go sideways and your health is at risk, you have this bigger threshold before death occurs. So last June, I contracted a Streptococcus A, invasive strep A, and I quickly went into toxic shock.
Wow.
My lungs filled with fluid. My heart, my lungs, or my kidneys, my liver went down to 20% function. I was on respirators. They had to put me on dialysis. I had rhabdomyolysis. My toes and my feet went black because I had clotting issues.
Oh.
So I didn't know how bad it was. I didn't know how severe this was. I just thought I was super sick. So I was in the ICU for 10 days. They had me on dialysis for 7 days. And then I was just under 5 weeks in the rehab floor at the hospital. And I lost 50 pounds. I went in at 220 pounds. I came out 170. And they had IVs in my arms because I had clots everywhere. They had to do surgery on my ankle because the infection got in there and destroyed the joint. So yeah, it was a big mess. And when I got into the rehab floor and I was feeling more myself, so to speak, at least coherent, I asked one of the docs, I'm like, kind of joking around, like, Doc, what were my odds? He's like, oh, less than 20%. I was like, oh wow, I was sick. He's like, you were super sick. He's like, and he shared with me, he's like, there were 4 other people that came in with what you had with less stuff going on. They didn't make it. I was like, oh wow. And they said the only reason you're still here is because of how fit you came in.
How fit?
Yes, how fit, how strong. My heart was strong, my lungs were strong. They thought I was going to be on dialysis for the rest of my life. My kidneys came back within a week.
Geez.
So all the, all the resilience, all the training, the exercise and the nutrition, you know, everything I've been doing for, you know, I'm 45 years old, for my entire life, it paid off. Because a lot of my friends came up to me and they're like, if this happened to me, I don't think I would have made it. I'm like, I don't know if you would have either, right? Like, but they were so surprised that this happened to me. I'm like, yeah, but I survived. And it's because— and it, it really shocked— it really kicked a lot of them in the ass to make sure, like, hey, you know what, you guys are my age. And they started taking their health seriously again, you know.
Yes.
Like, I get life gets busy, but, you know, we got to prioritize our health because if we're not healthy, we're not good to anybody.
If we're—
if we're here to service others, to help others, to be there for our families, if we're sick and ill and weak, we can't help them because we can't even, we can't help ourselves. Right. So people prioritize, if you don't prioritize your health, then you're, you know, and you prioritize others, it will eventually, it could catch up because it's your number one insurance policy that you can pay into. So, you know, and resiliency, it starts from, if you've never walked, go for a walk. If you've never done a pushup, do one. Um, you know, do bodyweight stuff, do squats, just do a little bit more every day. That's it. Like 1%, not even 1%, 0.1%.
Yes.
Just a little bit more to add that, that stress to the system so it has to adapt and it gets stronger and stronger and stronger. Because if we don't do that every day, the body is very— either you can either call it lazy or efficient. It will not waste energy on tissues it doesn't have to maintain. if you're not stressing those tissues and then adding the nutrition to build those tissues, it's like, why am I wasting energy? Muscle is very expensive. I'm just going to use this for fuel, right?
That's right.
But then all of a sudden, yeah, yeah, like, and then now you don't have the strength. I had to relearn how to walk. I was on a walker. I was in a wheelchair at the hospital. They had to teach me how to walk. I, like, nothing worked. I couldn't do anything for myself. And going from Completely independent, obviously independent, but everyone depending on me to help them. I couldn't go to the bathroom by myself. I couldn't— my wife had to shower me. Like, nothing. It was my nightmare. But it really made me appreciate, one, everything and everybody I have. But also, okay, all that work that I put in kept me here so I can be here with my family. And now I've built back up. So I'm, you know, my weight came back on pretty quick. I did all the right things. I just, I, I used my system to really rebuild myself from the ground up. I would— there's videos on me on YouTube where I'm kind of crawling on the ground and you see I'm all skinny and I'm like, okay, I'm just gonna do some breathwork with a lacrosse ball in my belly just to release all the tissue on the front, right? We're gonna do some glute bridges, we're gonna do some rolling. Okay, we're up to crawling now. I can hang off a bar a little bit. So, you know, I went into a little bit of that as much as I didn't want to do it to show people, but it was really a test of, you know what, it's time to put your money where your mouth is. You know, you've been doing this for 40+ years, but now you really have to rebuild from the ground up from zero.
Well, if that isn't resilience, I don't know what is. That's an incredible story from life-threatening to You look amazing now.
Oh, thank you.
It's incredible. And you know what that actually brings up, even though we have spoken, uh, primarily in this episode about, um, recovery and pain, etc., but we know that the importance really is prevention, isn't it? Even for anybody who may be older listening to this today, it's about how do I get myself up off the ground if I fall and I'm by myself?
Yep.
So that importance, isn't it, around— so it is of that importance around maintaining the muscle.
Yeah.
But is it not so that if you are going to the gym, even if you are, um, you know, more mature, but you have something out in your body, like your muscles might be out or your spine might be out, and you start doing all these exercises For prevention, can that create a problem?
It could. I mean, if you're lifting weights beyond your capacity, if you're moving them through ranges of motion that you haven't moved through in a long time, yeah, for sure. Because again, you know, if I've never reached my arm overhead, why— you know, it's probably not a smart idea to start doing pressing up there. I probably need to do some range of motion stuff first before I start putting a weight on that.
Yes.
If I've never squatted before, I'm not going to put a barbell on my back and go on the squat rack. Just do some bodyweight stuff. Start there. Hold on to a little kettlebell in the front here as a balancer, right? Like, there's lots of ways, there's lots of entry points. And again, if you're using pain as a guide and be like, okay, you know, I get to the squat, all right, my knees are a little bit sore here, I'm going to stop, come back up, and then just kind of buff that out. You know, those tissues need to start, they need to slide. And oftentimes it takes some repetitions and takes some heat and some blood flow to start to get them to loosen off. You know, they will cool down and they might feel stiff later, but again, if you show up again the next day and you do it, and the next day, it gets easier and easier. So it's removing a lot of that resistance in your body by adding resistance onto it. Because, you know, if I can deadlift 400 pounds, well, picking up my kid is no problem. I'm I'm not gonna hurt my back. Right?
Yes.
Whereas for a lot of people, that, that is a problem because I have that capacity to lift at such a high weight. Lifting the light things, it's easy. So the harder things that I do in my life, the easier my life gets.
Yeah.
If I do easy, if I do easy things in my life, the harder my life gets.
Yes. Yes. Tom, one of the things that I hear a lot of Here in Australia and with friends, etc., is oh, don't start with the chiropractor. Don't start with the physio because once you start, it never stops. You know, you have to keep going back. They keep making you go back. Yep. And that is such a resistance to some people going. So why do some people struggle to have these lasting results?
It's again, it's often because. The practitioners aren't looking— they're looking at the pain, they're chasing the pain, and they think that the pain is the problem, and they're just kind of putting Band-Aids on it. It will feel good. You know, you got a shoulder issue, we do some ultrasound, do some acupuncture, some soft tissue release. Yeah, it feels great. But if you're not looking at everything around the shoulder— well, what's the rib cage doing? What's the core doing? What's your single leg balance like? What's your neck doing? Well, the shoulder pain might come back, and oftentimes it does.
Yeah.
So when we look at the body as a system and we look at some of these injuries or repetitive injuries, like, well, this is a repetitive stress injury, is it? But the shoulder moves fine, but everything around it isn't. Well, that tissue got traumatized because it had an accumulation of forces that got into the tissues because it wasn't distributed or transmitted across the body effectively. So now all of a sudden we have this shoulder that's the most mobile joint in our body that moves really well you start to move more at it because you don't move through your rib cage, because you don't rotate through your neck. So your body's figured out, well, this joint moves pretty good, I'm just going to use a little bit more. So our body is really good at, at compromising quality for quantity. So if something's not moving, it's just going to move— it's going to find the next joint over and move more in that. So that's why it won't— it will never get better. And if we're just doing rotator cuff exercises, but not going after all those, you know, those major players around, it's just going to get hurt again from, you know, whatever the mechanism that they came in for initially. So when it comes to practitioners, they should be looking at the whole body first, figuring out what parts aren't moving. Zero, okay, yep, go touch the thing that, that's hurt because, you know, you've got to touch it, right, to make it feel better. You got to do some stuff on that if there's inflammation. But they should be looking at the system first. There should be education to tell you, okay, well, here's your exercises, here's your movement strategies, here's why we're doing it. And there should be an endpoint. Be like, well, when we're reassessing, if we're— if the assessment is now good, all your pieces and parts are moving, you're back to full activity, off you go. You should be gone.
Hmm.
You know, I look at my job as I should be doing a good enough job to put myself out of a job. Because if I'm doing my job, I'm teaching you how to do it yourself. Every assessment, you know, I talk to the patient. I'm like, I'm going to talk out loud so that you're aware of what you're doing so you can fix it, right? So we start talking about posture. Oh, you notice how you can't touch your toes? Notice how your neck is? Oh yeah, I do notice that. Okay, great. We're going to remember that for later. And then we start doing interventions and exercises. All right, let's recheck our work. Oh, I can touch my toes. Oh, my neck doesn't hurt. Awesome. So now you know the strategies that you need to do to fix yourself. So they get the homework, and then they come back, and then we reassess. Oh, we're going to progress it. We're going to peel back the layers. Oh, you know what? The neck's moving pretty good. We're going to go after your breathing, or we're going to go after your rib cage today. Like, we start peeling back the layers of onion so that we start getting all the pieces, get them to work, and then reintegrate them with the system again. So if it's never reintegrated Well, the nervous system is just going to keep doing what it knows how to do and move in that crappy way because there's no new programming installed. So again, this is where manual therapy always needs to be complemented by exercise, because if you just do the manual, yeah, it feels good for about a day or two, but then it comes back. Well, why? Because there was no new movement strategies in place to make up for the compensations. So what did the brain do? Well, it went back to its old compensations, created the pain again.
It's gone back to what it knows. It goes back to what it knows.
Exactly, because it's familiar.
Yeah, absolutely.
It's easy.
And that actually touches on what you said before, is that consistency is key. So if they've given you the exercises or the routines to do and you don't follow that up at home, well, you're going to be going back and back to the practitioner all the time.
All the time. So, and that 30 minutes, that 30-minute appointment is not going to make up for the over 1,000, you know, minutes in a week.
Yes.
So I tell people, I'm like, you're only here to see me for 30 minutes. The other 1,000 minutes is more important that you do with your day, being aware of your posture, your positions, doing, you know, doing your exercises. This is what's going to get you better. Like, I do these quick little resets to make you feel better, but the movement, the exercise, is what gets you better. And it's often not emphasized enough. It is the main thing that gets people off the table and out the door.
Yes, that's great advice. One of the main aims of this podcast is to actually help educate people who and what else is available for them, you know, within the alternative health space. So when selecting a practitioner, whether it's a chiropractor, physio, osteopath, musculoskeletal, whatever, does it come down to more preference or is it more condition individual base of what you're experiencing?
I would say it's preference. I mean, you— that coming back to the psychology component, It's help— it helps to have that connection. But even if that connection is not there, if the practitioner is explaining things to you in a way that you're like, oh, this makes sense, I'm going to do this, but you can kind of like— that's just another component. So they— the practitioners should be educating you, explaining everything to you, what's going on, why it happened, here's the plan of action, and then here's the eventual discharge at the end of the day. So We want to make sure that— oh, I lost my train of thought.
I'm glad it wasn't me for once. So we want to make sure that we either resonate with the practitioner or that practitioner has the ability for that particular condition.
It needs to be both. It's helpful to have both. Again, this comes back to if you're not connecting with a practitioner, You're not— that psychology component's not taken care of. So they can be the best practitioner in the world, but you're like, yeah, I mean, it makes sense what he's doing, but the underlying psychology or, you know, the nervous system might be like, yeah, I don't, I don't really trust what they say, or I don't feel— something feels off. But then you also can't have the practitioner who's, yeah, like, you know, super empathetic and super nice. Oh, I really like them, but they're not effective, right? Like, their techniques that they're using or the things that they're teaching just don't work. And I've seen both, right? But if you can marry the two, then it doesn't matter what title you have, whether you're a chiro, physio, osteo, you know, it doesn't matter at the end of the day. Because as long as they're teaching you, getting to the root cause, giving you new programming in the form of exercise, and they're getting meaningful lasting results, who cares? At the end of the day, all that matters is results.
That's really logical, solid advice there because you can be running from one to another to another thinking— I mean, some people definitely have their preferences. Some people don't like to have their neck or back cracked.
Sure.
So they definitely have their preferences, but it sort of narrows it down. It's not so much the modality, it's the person and how effective they are.
Yeah. And can they troubleshoot? So if something's not working, are they going to reassess and try a different route? try a different technique, or are they going to keep forcing the, the round peg into the square hole and, and hope that it works and hopes it makes a change? Well, doing the same thing over and over and expecting a different outcome, that's insanity. Now we— then we have to ask, well, who's more crazy, the practitioner or the patient who keeps giving them the money expecting a change? So I'm gonna say both.
Yeah, it's so true, isn't it? This has been such a fantastic episode. Tom, on not only guiding people to understand that they can help themselves, um, if you do have pain or injury, you know, it isn't so much like I've been told I have to go to a physio or I have to go to this. It's more about what you're saying. It's more about the person, their education, the flexibility of their thinking and mindset. And I don't think many people would have thought how important the nervous system is in their recovery. You know, it's—
It's, it's for how much I've really come to realize that the nervous system is the driving system, because it's about survival. It's about connection. Like, it has to do with mind, body. I mean, the nervous system transmits pain, it creates pain, it also creates suffering. So if you can't, if you can't make the nervous system happy, all the other systems aren't going to work like they should because it's shifting the body and everything in the wrong direction.
Yeah, that's solid, solid advice. To finish up today, can you share a strategy for improving mobility?
Yeah, so everyone should have this at home, right? A floor. Go sit on the floor. Something simple. You know, if, if we can't find time to go to the gym or exercise or what have you, if you have 15 minutes, you're watching TV before bed, simple, sit on the floor. Sit any way you want, because when you sit on the floor, it forces us to balance on our pelvis. So we have to find that good posture. Okay, well, when we do that, now our core muscles are working to at least a postural degree. Okay, at least in a low tone. If we're sitting cross-legged, we probably might only be able to do that for maybe 5, 6 minutes, and then all of a sudden the signal of discomfort, which is also the signal for change, comes in. So now we're getting this uncomfortable signal in the muscles saying, oh, you know what, you should probably change position now. Then you go into a shin box. All right, let's sit here for a while. Oh, but I've also figured out that I move differently right side and left side, so I should probably stay a little bit more in this position. Then we can do straddle. Then I can lay on my stomach. Then I can press up. Like, there's lots of different ways to mobilize the body just by sitting on the floor, watch TV, whatever it is you want to do for 15 minutes, and you'll be amazed at how much mobility improvement just occurs. And plus, having a good relationship with the floor— if we ever end up on the floor, we know how to manage our body when we get there, i.e., a fall. That's creating that relationship with the floor is key. Because everyone talks about fall prevention, but my question is, well, what happens when you can't prevent it? Yeah, how are you going to— how are you going to absorb those forces in your body if you don't have a relationship with the floor again? And that's where we first learn how to move as babies. What do babies do? They're rocking, they're rolling, they're crawling, like they're climbing on stuff, but their nervous system keeps them on the ground for anywhere from 9 months, year and a half, because it's setting up strength from the center. It's organizing all the center structures first before it starts to move to the periphery. It's organizing the vestibular apparatus, the visual system, proprioceptive systems, before it comes upright into a spine-stacked position against gravity. And if baby comes up too soon and tries to stand or walk when it's not ready, what happens to baby? Baby falls over. Nervous system said not yet. We still have some more work to do down here. So going back to the floor is a great way to reset our systems to start rebuilding movement from the ground up.
Yeah, that's, that's incredible. Because I think as you age, you almost have a fear of the floor. That's the last place you want to be, right? On the floor. Yeah. Because it's a matter of how do I get myself back up? Are my knees strong enough? Are my legs, you know, I'm in pain. We develop— I think we develop a fear of the floor.
Yeah, yeah. So every athlete, every client coming in, they're, they're doing some kind of floor work first, or they're doing some kind of crawl in their programs, just to again, like, add that variety, but add that awareness, control, inputs, variety, you know, novelty into the brain and the nervous system to have that relationship with the floor. Because sometimes We might end up on the floor when we least expect it.
That's great advice, Tom. I have loved this episode. Thank you so much for coming on to the show. And for everybody listening, Tom's details are in the show notes. Please do contact him, reach out to his company. There's so many people there that can help. Thank you so much for coming on.
Thanks for having me, Rita.
I would love to know what was the biggest insight or Aha moment you got from this interview, so you can now speak up, take action, and make informed decisions for your health. And if you like this episode, get instant access to your free ebook, Alternative Wisdom: Taking Back Control of Your Health, at life-onus.com.
