WEBVTT - #2117 Q & A With Dr Jeff Gross 0:00:00.320 --> 0:00:02.840 I get a team. It's your project. It's doctor Jeffrey. 0:00:02.960 --> 0:00:05.160 It's not real, it's doctor jeff it's me Harps, it's 0:00:05.160 --> 0:00:06.040 the bloody project. 0:00:06.080 --> 0:00:06.360 That's you. 0:00:06.519 --> 0:00:11.920 As I said, it's a seven o four in the 0:00:12.080 --> 0:00:14.720 am here in the thriving metropolis of Melbourne, down the 0:00:14.720 --> 0:00:17.240 bottom of Australia. If you're listening around the world, probably 0:00:17.360 --> 0:00:20.160 arguably the best part of Australia. But you know, other 0:00:20.200 --> 0:00:23.040 people will debate that. Of course, we're going to get 0:00:23.040 --> 0:00:25.799 the good doc out, hopefully this year. It would be 0:00:25.840 --> 0:00:30.800 good to get you over here at Bloody down Under 0:00:31.080 --> 0:00:34.880 so we can wheel you out like a prize possession 0:00:35.040 --> 0:00:37.720 to the masses, so that you can inspire and educate 0:00:37.720 --> 0:00:41.479 and inform. What do you think about that? We've spoken 0:00:41.520 --> 0:00:44.080 about it, but we need to maybe get the wheel 0:00:44.080 --> 0:00:44.879 turning slowly. 0:00:46.040 --> 0:00:47.800 I love it. I mean, if the Royal family can 0:00:47.800 --> 0:00:49.519 make a trip down there every now and then, why 0:00:49.600 --> 0:00:50.680 can't I? You know what I mean? 0:00:51.880 --> 0:00:58.480 I can not talk about the Royal family. I don't 0:00:58.520 --> 0:01:01.520 think he's in the royal family more. I think he's 0:01:01.880 --> 0:01:04.399 I think he's an ex royal. I don't know how 0:01:04.440 --> 0:01:07.200 that works. But how are you, mate, How's how's your 0:01:07.280 --> 0:01:10.640 month been. How are things going so good? 0:01:10.680 --> 0:01:12.800 I can't stand it, but thank you so much? And 0:01:12.920 --> 0:01:15.039 how are things by you? Yeah? 0:01:15.080 --> 0:01:18.360 Good? Two little curve balls over here, but that's life, 0:01:18.360 --> 0:01:22.280 but generally really good. And I feel like I'm going 0:01:22.360 --> 0:01:24.319 to sound like an old person, which clearly I am. 0:01:24.360 --> 0:01:26.800 But when I go, oh, can you believe it's already 0:01:26.840 --> 0:01:27.959 the third months of the. 0:01:28.080 --> 0:01:31.960 Year, Jeff, Oh wow, that is what all people say. 0:01:32.760 --> 0:01:37.160 Yeah, it's much already. Bro. All right, So last time, everyone, 0:01:37.480 --> 0:01:39.520 the good doc and I did a Q and A, 0:01:40.440 --> 0:01:43.039 so let's jump to that. I got some really good, 0:01:43.160 --> 0:01:45.680 really good the best feedback that we've had about any 0:01:45.680 --> 0:01:47.760 of the episodes that we've done, and it's always positive. 0:01:47.760 --> 0:01:50.040 But I got not just good feedback, but a lot 0:01:50.040 --> 0:01:56.120 of feedback, like the volume was times five. So and 0:01:56.160 --> 0:01:58.120 a few people went, can you do a version of 0:01:58.120 --> 0:02:01.000 that again? And I went, well, fuck it, let's do it. 0:02:01.920 --> 0:02:05.440 Let's just break the fucking typ rules that Melissa and 0:02:05.440 --> 0:02:11.480 Tiff make and list let's just plow some new grounds. 0:02:11.480 --> 0:02:13.080 So we're going to do that, and we might do 0:02:13.160 --> 0:02:15.119 one of these each month. We're not sure. We'll see 0:02:15.120 --> 0:02:19.680 if you like them. So the idea is this, and 0:02:19.760 --> 0:02:22.480 again None of this is a prescription. This is just 0:02:22.680 --> 0:02:26.080 the doc and I talking and him sharing his thoughts 0:02:26.160 --> 0:02:30.200 on these particular things. Obviously as a medialone assessed anyone, 0:02:30.360 --> 0:02:33.079 and so it's just conversation. But take from it what 0:02:33.160 --> 0:02:36.520 you will, do with it what you will and maybe 0:02:37.280 --> 0:02:41.000 ignore it or explore it, maybe open a new door 0:02:41.040 --> 0:02:43.720 and go and have a chat to somebody to further 0:02:43.800 --> 0:02:47.919 this chat that you hear, and you might hear something 0:02:48.000 --> 0:02:52.160 that could potentially change your life, which would be nice. 0:02:52.760 --> 0:02:56.079 And so I've asked people to send in quite specific 0:02:56.240 --> 0:03:02.079 medical or clinical or injury questions, so there's zero kind 0:03:02.160 --> 0:03:05.560 of fluff. And I asked all of those questions. I 0:03:05.600 --> 0:03:08.280 asked everyone to send stuff that's really a personal question 0:03:08.360 --> 0:03:13.360 about them rather than a broad generic question about integrated 0:03:13.400 --> 0:03:15.920 medicine or anything like that. So here we go, Steve 0:03:17.320 --> 0:03:20.680 from What's funny is after the last one, everybody writes 0:03:20.720 --> 0:03:24.520 their name and then their birth or their age. So 0:03:25.160 --> 0:03:28.160 Steve fifty four Mornington. Not everyone, but most people I've got. 0:03:28.760 --> 0:03:30.840 I feel like some of these I could answer, but 0:03:31.000 --> 0:03:33.840 I won't. I've got bone on bone arthritis in my 0:03:33.919 --> 0:03:38.200 right hip. I'm still surfing and walking daily, but it's 0:03:38.240 --> 0:03:42.520 getting difficult. Is there any anything regenerative that realistically buys 0:03:42.560 --> 0:03:44.640 me any time before a hip replacement? 0:03:47.120 --> 0:03:50.720 Absolutely? You know, first of all, if you are still 0:03:50.720 --> 0:03:55.920 doing those things, awesome, and that tells us there's some cartilage. Right, 0:03:55.920 --> 0:03:58.080 you're not exactly bone on bone, you would not be 0:03:58.080 --> 0:04:00.440 able to do those things. Bone on bone is sort 0:04:00.440 --> 0:04:04.800 of this misused phrase just to scare people into a 0:04:04.840 --> 0:04:09.640 surgical joint replacement. So yeah, we've had some success following 0:04:09.640 --> 0:04:13.920 a French protocol. The French have published over fifteen years 0:04:13.920 --> 0:04:18.640 of using stem cell biologics surrounding the joint in the 0:04:18.640 --> 0:04:24.440 bone edges, restimulating the factory that produces cartilage that because 0:04:24.480 --> 0:04:29.159 of inflammatory changes over life and age, you're unable to 0:04:30.320 --> 0:04:32.920 you know, you know do on your own, So we 0:04:32.920 --> 0:04:38.599 can restimulate those areas. We have good success in having 0:04:38.640 --> 0:04:41.520 you rebuild your cartlage. Remember you made that cartilage in 0:04:41.520 --> 0:04:45.159 the first place, Steve, and you're you're fairly young. So 0:04:45.400 --> 0:04:49.000 a joint replacement is an option. But man, if we 0:04:49.000 --> 0:04:52.480 could fix this with a single injection and you get 0:04:52.480 --> 0:04:55.080 a trip to Las Vegas out of it, to boot, 0:04:55.200 --> 0:04:59.360 I think I think you're saving money and recovery time 0:04:59.400 --> 0:05:05.320 and mist and missurfing, and you know your body has 0:05:05.400 --> 0:05:08.880 the blueprint to make cartilage. Sometimes it just needs a reminder. 0:05:10.120 --> 0:05:12.480 And I would also guess that if he's fifty four 0:05:12.520 --> 0:05:16.440 and surfs every day and walks every day, he's probably 0:05:16.640 --> 0:05:22.320 other than these shitty hit he's probably biologically younger than 0:05:22.360 --> 0:05:25.200 fifty four, you know what I mean, from a kind 0:05:25.240 --> 0:05:26.680 of profile point of view. 0:05:27.480 --> 0:05:30.560 I would concur with that. I would concur with that completely. 0:05:30.720 --> 0:05:33.600 So we are seeing benefits in this. And even if 0:05:33.640 --> 0:05:37.599 you have a cartilage tear some old injuries, you know, 0:05:38.600 --> 0:05:42.080 when you're young and have those things, you heal relatively well. 0:05:42.200 --> 0:05:45.200 We just need to turn on your fifty four year 0:05:45.240 --> 0:05:49.800 old hit to heal like an eighteen year old for 0:05:49.839 --> 0:05:53.920 a bit and then you're right back in your regular programming. 0:05:57.440 --> 0:06:00.360 By the way, this is a sidebar, but I used 0:06:00.360 --> 0:06:04.320 to work in Sport radio in Melbourne for about fifteen 0:06:04.400 --> 0:06:08.359 years and just as the excise science guy and hosting 0:06:08.440 --> 0:06:10.560 and stuff. But I used to do a show where 0:06:10.560 --> 0:06:14.800 every week people would just bring up and ask questions 0:06:14.880 --> 0:06:19.040 and just general stuff, some specific, some general. But we 0:06:19.080 --> 0:06:22.240 did this kind of thirty minute segment on people had 0:06:22.240 --> 0:06:24.520 to ring up and say if you could only do 0:06:24.680 --> 0:06:29.280 one activity or one exercise, what do you think would 0:06:29.320 --> 0:06:37.640 be the single most kind of all encompassing, physiologically beneficial 0:06:40.160 --> 0:06:46.280 kind of activity. And I came up with surfing. Let 0:06:46.279 --> 0:06:49.880 me tell you why. When you're surfing, so you need 0:06:50.080 --> 0:06:56.880 muscular endurance, aerobic endurance, strength, power, speed, agility, balance, You're 0:06:56.920 --> 0:06:59.920 in nature. It's fucking beautiful unless you get eaten bioshark, 0:07:00.040 --> 0:07:04.240 which is a seventeen percent chance in Australia. But there 0:07:04.279 --> 0:07:06.880 are just so many things that you need to be 0:07:06.960 --> 0:07:10.400 able to learn to surf and then to be able 0:07:10.440 --> 0:07:15.320 to surf. And you're moving in different planes, like your 0:07:15.360 --> 0:07:18.280 feet are facing that way, your hips are there, your 0:07:18.280 --> 0:07:22.000 shoulders are there. You're constantly moving. You're constantly adapting to 0:07:22.160 --> 0:07:27.200 something which is dynamic, it's not static. What would you pick? 0:07:27.240 --> 0:07:29.880 What would be? It's something if we're thinking about like 0:07:30.360 --> 0:07:34.000 a movement or an exercise or an activity which would 0:07:34.560 --> 0:07:39.440 involve so many different components of your physiology anatomy in 0:07:39.480 --> 0:07:42.360 a functional way. What would be in your top five? 0:07:42.480 --> 0:07:45.000 Not necessarily number two on that list, or you might 0:07:45.040 --> 0:07:46.960 have a number one that supersedes mine. 0:07:48.640 --> 0:07:51.120 And I love the surfing concept. I'd like to add 0:07:51.160 --> 0:07:54.520 one more ingredient to your surfing, and that is you 0:07:54.640 --> 0:07:57.640 also do a lot of good postural work because when 0:07:57.640 --> 0:08:02.520 you have to paddle, your engaging your spinal muscles, you know, 0:08:02.600 --> 0:08:06.000 to arch your back and that, you know, besides all 0:08:06.000 --> 0:08:10.120 the core and small stabilizer muscles you use when you're 0:08:10.440 --> 0:08:13.120 bouncing on the board. There's so many things I like 0:08:13.200 --> 0:08:17.480 that I hadn't considered that. I would probably go pilates 0:08:18.680 --> 0:08:24.880 and maybe yoga, power yoga or a sculpting yoga plates 0:08:25.040 --> 0:08:29.040 because you can do cardiovascularly in there. You can you 0:08:29.080 --> 0:08:31.400 can get the core and the stabilizers, you can get 0:08:31.400 --> 0:08:34.560 the big muscle groups you get you get a lot 0:08:34.600 --> 0:08:38.640 of the twisting and the and the stretch component. Maybe 0:08:38.640 --> 0:08:40.640 not as much cardio, and of course you gotta go 0:08:40.720 --> 0:08:45.040 heavy if you want to get the power piece. And 0:08:45.040 --> 0:08:49.120 and I would I would consider those, you know, I 0:08:49.600 --> 0:08:52.480 like some of these fitness classes that involve a little 0:08:52.480 --> 0:08:55.720 of everything. They have all kinds of different branded names 0:08:55.760 --> 0:08:58.959 over here, but you know they've got some you know, 0:08:59.040 --> 0:09:02.439 high intensity card they've got some powers, some lifting SATs, 0:09:02.520 --> 0:09:07.120 they've got some playability, they've got some calisthenics, and they 0:09:07.200 --> 0:09:11.080 keep you moving fast and very little rest. I like those, 0:09:13.760 --> 0:09:14.360 and yet. 0:09:14.240 --> 0:09:18.840 They have so over here CrossFit forty five high rocks. 0:09:19.160 --> 0:09:22.800 It's all kind of year circuity based, like you said, 0:09:22.840 --> 0:09:25.720 bit of strength, bit bit of agility, bit of upper 0:09:25.800 --> 0:09:29.679 lower body, lots of cardio. Yeah, they're good. I just 0:09:29.720 --> 0:09:35.560 think people need to be You need to be integrated 0:09:35.600 --> 0:09:38.559 into those programs at the right level for where you 0:09:38.640 --> 0:09:41.880 are at. And because they're not personal one on one 0:09:41.920 --> 0:09:44.880 their group. Yeah, you just need to be careful which 0:09:44.920 --> 0:09:48.720 group you slot into or you could hamstring off your 0:09:48.720 --> 0:09:50.800 bone till about twenty twenty eight. 0:09:51.520 --> 0:09:56.920 So that's happening. We do see a bit of injuries 0:09:57.280 --> 0:10:02.160 from CrossFit, from people pushing it too far too much, 0:10:02.760 --> 0:10:07.720 or like you said, stepping in at the the provider, 0:10:07.760 --> 0:10:09.480 the men going I got this. I used to do 0:10:09.520 --> 0:10:11.520 this all the time, and they're just not in shape 0:10:11.559 --> 0:10:12.640 or stretched out. Yeah. 0:10:12.920 --> 0:10:16.320 Yeah, it's the dude that's at level two going to 0:10:16.400 --> 0:10:19.200 the level eight group. Fuck it, I'll be fine. Do 0:10:19.200 --> 0:10:20.200 you know what I used to do? 0:10:20.559 --> 0:10:20.920 All right? 0:10:21.040 --> 0:10:25.000 Rachel forty three. Rachel forty three from Melbourne says I 0:10:25.040 --> 0:10:28.200 tore my ACL five years ago and I did not 0:10:28.280 --> 0:10:32.920 have surgery. Oh it's mostly okay, but feels unstable when 0:10:32.920 --> 0:10:38.439 I pivot. I'm not surprised, Rachel. Can regenerative treatment improve 0:10:38.520 --> 0:10:41.440 stability or is that purely structural? 0:10:43.080 --> 0:10:47.840 Great question, Rachel. So I'm guessing that it's not a 0:10:47.880 --> 0:10:53.640 complete tear, Otherwise you would really really unstable. So we've 0:10:53.679 --> 0:10:56.840 had some success in the incomplete tears. Otherwise, Yes, it 0:10:56.960 --> 0:11:01.240 is fairly structural. So the problem here is she tore 0:11:01.240 --> 0:11:04.280 it a while back, so it's not cute, and she 0:11:04.400 --> 0:11:07.000 may have forms scar tissue at the edges of the 0:11:07.080 --> 0:11:10.200 ten drills, so we may not get benefit. We like 0:11:10.320 --> 0:11:14.760 to hit these early, and our best results are, you know, 0:11:14.800 --> 0:11:17.839 within a few weeks of the injury, and we're getting 0:11:18.480 --> 0:11:21.960 in there and having it heal like a youthful you know. Way, 0:11:22.200 --> 0:11:25.040 if there are some of the fibers still intact, then 0:11:26.000 --> 0:11:31.040 the edges haven't pulled apart and retracted it away. Otherwise, 0:11:31.080 --> 0:11:33.959 if you put regenerative medicine there, it's unlikely that those 0:11:34.480 --> 0:11:38.840 those two pieces will find each other and heal them. Yep. 0:11:40.440 --> 0:11:47.800 Perfect Andrew from Bellarat High Bellarat, That's where I was born. 0:11:47.880 --> 0:11:52.520 Shout out to Bellarrat. I have got chronic planta fasciata 0:11:52.640 --> 0:11:55.600 subtrid orthotic stretching shock wive therapy. I don't even know 0:11:55.640 --> 0:12:01.000 what that is, Andy, Uh, it keeps coming back. Would 0:12:01.080 --> 0:12:04.560 something like payo stem cells help. 0:12:05.679 --> 0:12:08.880 Yes, we've had some success there, But let's go back 0:12:08.880 --> 0:12:12.400 and define shockwave therapy, Craig, because I think that's something. 0:12:12.280 --> 0:12:13.960 Tell me hit me up by a cop. 0:12:14.800 --> 0:12:18.040 So if you if you had a kidney stone and 0:12:18.080 --> 0:12:22.280 you didn't want a surgery to dig it out of you, there, 0:12:22.920 --> 0:12:26.040 you would you would go into a medical facility that 0:12:26.120 --> 0:12:30.600 has this this high intense the sound wave generator, and 0:12:30.640 --> 0:12:32.959 it would they put your kidney right up against it 0:12:33.000 --> 0:12:37.559 and target this through through these these these shocks of sound, 0:12:37.760 --> 0:12:41.680 sound shocks. Yes, like you're at a rock and roll concert, 0:12:42.240 --> 0:12:44.559 right up against the big speaker in the front and 0:12:44.760 --> 0:12:47.040 just the sub whopper woofer is just pounding away at 0:12:47.040 --> 0:12:53.240 your kidney, pulverizing that. Uh that Califi Kinney saying. Well, 0:12:53.440 --> 0:12:58.240 turns out shock wave therapy is getting increased utilization in 0:12:59.040 --> 0:13:07.320 other tendon, ligament and even bone injuries to help in 0:13:07.360 --> 0:13:12.320 that regard. Now, in fashi fascia itis is the is 0:13:12.360 --> 0:13:16.960 the plantar fascion that's the big, broad, tough gristly tissue 0:13:17.000 --> 0:13:19.800 at the bottom of the foot and over time it 0:13:20.120 --> 0:13:23.880 gets it gets over tight and it's painful with pressure 0:13:24.160 --> 0:13:28.960 and it's hard to work out. And shockwave. He tried shockwave. 0:13:29.000 --> 0:13:31.600 That's a reasonable approach, but it didn't work. So, yes, 0:13:31.679 --> 0:13:35.520 there's an inflammatory component and we know that because plantar 0:13:35.600 --> 0:13:39.720 fasci itis ends in itis. Itis is the Latin root 0:13:39.800 --> 0:13:43.960 for inflammation. So there have been benefits with using regenerative 0:13:44.040 --> 0:13:47.840 biologics injected into that area, whether it be p RP, 0:13:48.520 --> 0:13:54.240 stem cells, stem cell derived exosomes, maybe some peptides. I 0:13:54.280 --> 0:13:58.320 would I would try all those things, and I would 0:13:58.360 --> 0:14:01.000 avoid they have these surgeries and the surgeries tend to 0:14:01.040 --> 0:14:04.199 not work out so well. I would try some different 0:14:04.280 --> 0:14:09.480 anti inflammatory injections like I just described, with biologics, peptides, 0:14:10.240 --> 0:14:14.360 and you know, some type of method. Maybe you continue 0:14:14.400 --> 0:14:16.280 with the shockwave because you got to find a way 0:14:16.320 --> 0:14:18.679 to tenderize the meat down there, if you know what 0:14:18.760 --> 0:14:19.040 I mean. 0:14:20.040 --> 0:14:26.320 Wow, that's graphic. Yep. When you're talking about shockwave therapy, 0:14:26.360 --> 0:14:30.240 I was thinking about potential military applications. You know, that's 0:14:30.360 --> 0:14:35.320 just me, haven't didn't Isn't that what some countries have 0:14:35.400 --> 0:14:41.280 allegedly used in recent operations or something? Similar. But enough 0:14:41.320 --> 0:14:45.360 about that. That was Andrew. Let's get Andrew off the screen. 0:14:45.560 --> 0:14:50.080 Let's go to Melissa. Oh, I've been diagnosed. Melissa is 0:14:50.120 --> 0:14:54.320 thirty nine and from Sydney. Hello Melissa from Sydney. I've 0:14:54.320 --> 0:14:58.160 been diagnosed with early degenerative disc disease in my neck. 0:14:58.880 --> 0:15:02.480 I get headaches and I'm tingling plays with a lot 0:15:02.520 --> 0:15:04.360 of A's plays. 0:15:04.120 --> 0:15:09.640 Help absolutely since because of the extra ease. So the 0:15:09.680 --> 0:15:12.440 phrase degenerative dis disease is not a great phrase, but 0:15:12.560 --> 0:15:15.640 many doctors use it because it clearly, it quickly tells 0:15:15.640 --> 0:15:17.600 you the kind of thing you have. But let's face 0:15:17.640 --> 0:15:21.960 it, it's not a disease. It is a is a degenitive 0:15:21.960 --> 0:15:28.000 collection of microtrauma, sometimes big traumas that accumulate and allow 0:15:28.160 --> 0:15:33.520 for the discs to be less functional as cushions. They 0:15:33.560 --> 0:15:39.600 become shorter, they become drier, and then they can tear 0:15:39.640 --> 0:15:42.320 and hurting it just like carlogen and knee or somewhere else, 0:15:43.280 --> 0:15:45.640 uh with When you lose the disc, then you start 0:15:45.640 --> 0:15:48.400 to form bone spurs, and the combination of the spurs 0:15:48.440 --> 0:15:51.880 and the loss of disk function and height is is 0:15:51.960 --> 0:15:56.640 this degenitive process that is unfairly called the disease, degenerative 0:15:56.640 --> 0:16:00.160 dis disease. So if your doctor used that phrase, they 0:16:00.520 --> 0:16:05.560 that means they were saving themselves at fifteen minute explanatory conversation. 0:16:06.200 --> 0:16:11.360 So be that as it may be. Yeah, right the 0:16:11.480 --> 0:16:16.960 tree right now, she's got some arm symptoms. Yeah, likely 0:16:17.040 --> 0:16:20.640 because you know, as as the discs shortened, so do 0:16:20.840 --> 0:16:24.400 the exiting windows where the nerves leave your spine to 0:16:24.400 --> 0:16:28.280 go down your arm. Yeah, and as it pertains to 0:16:28.320 --> 0:16:31.440 the neck. Of course, in your lower back, those pathways 0:16:31.560 --> 0:16:34.200 go down the lake. But in the neck, you know, 0:16:34.200 --> 0:16:37.440 when they become smaller, then you're more likely to irritate them. 0:16:37.440 --> 0:16:41.720 In certain positions, feel either numbness, tingling, or zingers of 0:16:41.760 --> 0:16:44.720 pain down the arm. And sometimes it's bad enough that 0:16:44.720 --> 0:16:47.160 that nerve is is you know, you get weak, it 0:16:47.240 --> 0:16:52.200 can be really bad. So if you know, anything you 0:16:52.240 --> 0:16:59.560 can do short of surgery is key. So really good stretching, yoga, flexibility, 0:16:59.600 --> 0:17:03.920 because you know, you hear you've you've heard this phrase 0:17:04.200 --> 0:17:07.720 that you bend until you break. So we want you 0:17:07.760 --> 0:17:10.240 to be able to bend further. So you so breaking 0:17:10.359 --> 0:17:13.280 is further down the list of things to do. We 0:17:13.359 --> 0:17:18.280 want you to improve you know your you know, muscle 0:17:19.000 --> 0:17:22.200 tone of flexibility and the fascial release. This goes off 0:17:22.240 --> 0:17:25.080 obviously with the planner flashy fasci I just answer as well, 0:17:25.080 --> 0:17:28.280 but I'm a big fan of en type yoga for this. 0:17:29.600 --> 0:17:34.919 And then a good a good deep tissue sports massage, 0:17:34.960 --> 0:17:39.320 a really good mile fascial release, not not a little 0:17:39.440 --> 0:17:42.280 fufu you know rub down. Okay, you got to get 0:17:42.280 --> 0:17:45.439 the real deal. Really, if it didn't hurt somewhat, if 0:17:45.480 --> 0:17:48.120 it wasn't tough on you, you know, and you weren't 0:17:48.200 --> 0:17:51.720 grunting and grown and during the massage, and that's not therapeutic. Really, well, 0:17:53.000 --> 0:17:55.399 I suppose the fufu ones are therapeutic for your brain, 0:17:55.960 --> 0:17:58.960 but the the we we really need to loosen up 0:17:58.960 --> 0:18:02.960 those tissues and then and then the MRI is the 0:18:03.000 --> 0:18:06.960 best way to study if the nerve is compromised physically 0:18:07.160 --> 0:18:10.560 or not so physically might mean, you know, is is 0:18:10.600 --> 0:18:12.800 it being something pushing on it? Or what we call, 0:18:13.359 --> 0:18:17.000 you know, commonly we refer to this as a pinched nerve, 0:18:17.760 --> 0:18:21.120 even though it's technically not always pinched, just be pushed 0:18:21.280 --> 0:18:26.160 or touched or irritated, impinged in some way. Impingement is yeah, 0:18:26.200 --> 0:18:29.800 we see that word as well, exactly, so you know, 0:18:29.840 --> 0:18:32.520 they can be bad enough to need surgery, and before 0:18:32.560 --> 0:18:35.960 you have surgery, they'll exhaust all other options. So there 0:18:36.000 --> 0:18:38.399 are some injections that can be done to suppress the 0:18:38.440 --> 0:18:41.760 inflammatory burden and allow you to do the rehab to 0:18:41.800 --> 0:18:44.880 overcome this. You got to You got to get ahead 0:18:44.880 --> 0:18:46.600 of it and stay ahead ahead of it. She's only 0:18:46.720 --> 0:18:51.080 thirty nine, so I don't know. Is she an ex gymnast? 0:18:51.280 --> 0:18:52.520 Is she you know? 0:18:52.640 --> 0:18:52.680 What? 0:18:52.960 --> 0:18:57.240 Whatlissa? What did you do to end up with this 0:18:57.280 --> 0:18:59.199 so early? Were you in a car wreck at some 0:18:59.280 --> 0:19:01.560 point that tolerated the process, et cetera. 0:19:02.760 --> 0:19:08.000 Yes, yes, they are good questions. I reckon, like I 0:19:08.040 --> 0:19:12.080 would not want my spine or all the bits and 0:19:12.160 --> 0:19:16.520 pieces of my spine from lumber through to a cervical 0:19:16.640 --> 0:19:20.480 to be or curvical. I would not want my spine 0:19:20.520 --> 0:19:22.679 to be looked at too closely because I reckon they 0:19:22.720 --> 0:19:25.840 would go, how the fuck are you walking? Do you 0:19:25.920 --> 0:19:28.479 not have constant pain? Because I've had so many injuries 0:19:28.520 --> 0:19:30.560 sort of doing dumb shit in the gym and outside 0:19:30.640 --> 0:19:35.280 the gym? I think, do you not think that most people, well, 0:19:35.320 --> 0:19:38.040 Melissa is young, but like fifty and onwards would have 0:19:38.320 --> 0:19:43.000 some kind of observable degeneration or issue if everyone went 0:19:43.040 --> 0:19:46.000 and had had their backlooked at or X rayed or 0:19:46.040 --> 0:19:46.879 scanned or whatever. 0:19:47.760 --> 0:19:52.000 Yes, and there are studies that show that each decade 0:19:52.080 --> 0:19:56.240 brings a higher chance of finding something anatomically degenerating in 0:19:56.280 --> 0:20:00.159 the spine, but only the minority of people actually have 0:20:00.240 --> 0:20:04.320 ongoing symptoms related to said degenerative faintings. 0:20:04.560 --> 0:20:06.919 That's so interesting. We have a guy who's been on 0:20:07.000 --> 0:20:10.199 quite a few times. He's a sports doctor and he 0:20:10.240 --> 0:20:14.560 specializes in pain management, and he's got a very different 0:20:15.119 --> 0:20:18.119 kind of outside the box approach. So it's not in 0:20:18.160 --> 0:20:20.360 managing pain with heaps of drugs and this, and it's 0:20:20.359 --> 0:20:24.200 more about it's quite de been philosophical, but trying to 0:20:24.280 --> 0:20:26.240 understand the pain and a whole lot of things that 0:20:26.280 --> 0:20:31.280 I find really fascinating. But he gave a presentation to 0:20:31.320 --> 0:20:34.720 a whole lot of doctors and he showed this X 0:20:34.840 --> 0:20:39.320 ray I guess of a sixty one year old back, 0:20:40.600 --> 0:20:44.240 and he just put it up or a couple of 0:20:44.520 --> 0:20:46.919 X rays up and said, you know, kind of open, 0:20:46.960 --> 0:20:51.000 interactive kind of audience. What do you think what's going 0:20:51.040 --> 0:20:53.239 on here? Or what would you recommend if you know, 0:20:54.400 --> 0:20:56.600 if you had this patient and they're all like, or 0:20:56.640 --> 0:20:59.159 what are your thoughts? And they're like, wow, he must 0:21:00.240 --> 0:21:04.560 he fucked he needs surgery. By lunchtime, he's you know, 0:21:04.680 --> 0:21:08.560 he probably can't walk Da da da da da. And 0:21:08.600 --> 0:21:11.000 he said, what would you say if I told you 0:21:11.040 --> 0:21:14.960 that this patient rides two hundred kilometers a week. So 0:21:15.000 --> 0:21:17.760 he rides I think four days a week fifty ks, 0:21:17.800 --> 0:21:21.080 which is thirty miles in your language, and blah blah 0:21:21.080 --> 0:21:22.919 blah blah blah. And by the way, this patient is 0:21:23.000 --> 0:21:27.560 me so and they're like, and he was up there 0:21:27.600 --> 0:21:31.840 on stage presenting and moving well and yeah. So it's 0:21:31.960 --> 0:21:35.040 like it doesn't necessarily what seems to be or what 0:21:35.119 --> 0:21:39.600 it is apparently going on isn't necessarily reflected in symptoms 0:21:39.800 --> 0:21:43.600 that like, not consistently anyway. 0:21:43.960 --> 0:21:46.800 That's an important point that let's do that both directions. 0:21:47.359 --> 0:21:50.119 Films don't always the imaging the X ray is, the 0:21:50.200 --> 0:21:53.840 MRIs don't always say what's going on symptomatically, and the 0:21:53.920 --> 0:21:57.080 symptoms don't always predict what the MRI or X rays 0:21:57.080 --> 0:22:01.240 will show. That's why the true act, the true cognitive 0:22:01.240 --> 0:22:05.520 act of being a clinician, is to correlate them. It's 0:22:05.520 --> 0:22:09.760 called the clinical correlation, you match them. So in the 0:22:09.800 --> 0:22:14.680 case of your doctor friend, you know he has imaging 0:22:14.760 --> 0:22:17.240 findings that are not clinically correlated with how he's doing. 0:22:17.240 --> 0:22:21.000 He's doing much better than the imaging would suggest. But yeah, 0:22:21.080 --> 0:22:23.359 he learns from that and he says, well, I've got 0:22:23.400 --> 0:22:26.080 a bad spine. I should be careful. I can do 0:22:26.119 --> 0:22:28.600 all the cycling. I just better not fall. I'm at 0:22:28.680 --> 0:22:29.320 higher risk. 0:22:32.119 --> 0:22:36.320 ALRIGHTY appreciate that. Natalie from Geelong, which is down here 0:22:36.400 --> 0:22:38.560 in the state. I live in Dock. It's about an 0:22:38.560 --> 0:22:41.600 hour away. Natalie says forty seven. By the way, I've 0:22:41.600 --> 0:22:44.439 got a frozen shoulder that's lasted nearly a year. I 0:22:44.440 --> 0:22:47.000 feel like we had a frozen shoulder last time. But anyway, 0:22:47.280 --> 0:22:49.439 I've got a frozen shoulder that's lasted nearly a year. 0:22:49.520 --> 0:22:52.879 Physio helps a bit, but progress is slow. Wow, I 0:22:52.880 --> 0:22:55.960 would say, so can injections. I don't know what kind 0:22:56.000 --> 0:22:59.680 of injection. She means, accelerate that process. 0:23:00.800 --> 0:23:02.280 Yeah, there are a couple of things you can look 0:23:02.320 --> 0:23:05.200 at for this, because listen, if it's been a year, 0:23:05.280 --> 0:23:07.199 you're going to have to get more aggressive if you 0:23:07.359 --> 0:23:10.880 ever want that shoulder range of motion back and that 0:23:10.960 --> 0:23:15.920 aggression may come through some numbing injections, some steroid injections, 0:23:15.920 --> 0:23:17.760 although I'm not a big fan of repeating those over 0:23:17.800 --> 0:23:21.160 and over. They have a downside, and or regenitive injections. 0:23:21.920 --> 0:23:24.240 But there's something called, we call it here in the 0:23:24.240 --> 0:23:32.200 States m U a manipulation under anesthesia where an anesthesiologist 0:23:32.320 --> 0:23:35.040 knocks you out for a few minutes and your orthopedics 0:23:35.119 --> 0:23:39.280 or sports specials comes in and wrenches your shoulder a 0:23:39.760 --> 0:23:44.639 god bristle. Wait, let's let's be more graphic, breaking it up, 0:23:44.680 --> 0:23:50.760 you know, ah, and and unfreezing the very the very 0:23:51.480 --> 0:23:53.879 frozen shoulder that you have, breaking up that crystal so 0:23:54.280 --> 0:23:56.639 and and then then you can really get into the 0:23:56.640 --> 0:24:00.720 rehab more aggressively. Now I will say, now age again 0:24:00.800 --> 0:24:05.240 of this nice person from Geelong, Natalie from Geelong forty seven. 0:24:06.080 --> 0:24:09.280 So this, this is very common in a we'll call 0:24:09.320 --> 0:24:14.400 it a menopausal or perimenopausal group. This is this would 0:24:14.400 --> 0:24:19.840 benefit also from looking at bioidentical hormone optimization. There are 0:24:19.880 --> 0:24:23.639 hormone receptors in the in the in the tissues of 0:24:23.680 --> 0:24:26.720 the joint. We've got to look at the bone, of course, 0:24:26.920 --> 0:24:29.959 you know, knowing what's going on in there cartilage wise 0:24:30.040 --> 0:24:32.280 and bone wise is very important. So if she's only 0:24:32.359 --> 0:24:34.240 had an X ray, she's a candidate for a good 0:24:34.280 --> 0:24:39.159 quality MRI to see what's what's causing her not to 0:24:39.200 --> 0:24:42.199 be so frozen. Is it an old injury that just 0:24:42.240 --> 0:24:45.600 got stuck. Is it just accumulation of degenerative changes that 0:24:45.640 --> 0:24:50.120 have accelerated. Let's let's dig in and get real granular 0:24:50.160 --> 0:24:53.200