Digital Social Hour - Tom Walters On Chiropractors, Best Time of Day to Stretch & Causes of Neck & Back Pain| DSH #153

Episode Date: November 10, 2023

On today's episode of Digital Social Hour, we sit down with Dr Tom Walters to find out what causes chronic pain, what causes shin splints and we bust the myth of cracking your fingers being bad for you. BUSINESS INQUIRIES/SPONSORS: [e-mail] APPLY TO BE ON THE POD: https://forms.gle/qXvENTeurx7Xn8Ci9 SPONSORS: Opus Pro: https://www.opus.pro/?via=DSH HelloFresh: https://www.hellofresh.com/50dsh AG1: https://www.drinkAG1.com/DSH Hostage Tape: https://hostagetape.com/DSH LISTEN ON: Apple Podcasts: https://podcasts.apple.com/us/podcast/digital-social-hour/id1676846015 Spotify: https://open.spotify.com/show/5Jn7LXarRlI8Hc0GtTn759 Sean Kelly Instagram: https://www.instagram.com/seanmikekelly/ Learn more about your ad choices. Visit megaphone.fm/adchoices Learn more about your ad choices. Visit podcastchoices.com/adchoices

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friend works in an ER. He's actually seen some paralysis. Where do you stand on them? The problem is when you get chiropractors to sort of act like they're MDs and it's just dishonest. In a lot of cases, if you look at mortality, you know, I mean maybe you had a grandparent who fell and fractured a hip or something like that. It's those types of issues when people get older and they become frail are a lot of times what end up causing them to be sedentary.

So like somebody falls down, then they have what's called a fear of falling. I mean it's a really high, the number of people that die, older people that die after a hip fracture,'s like 30 die in the next year whoa welcome back to the digital Social Hour, guys. I'm your host, Sean Kelly. Here with my co-host, Charlie Cavalier and Dr. Tom Walters. Thanks for having me, guys.

It's awesome to be here. Thank you. Absolutely, man. So I've been seeing your clips everywhere on social media, so I had to reach out to you. Oh, man. It's awesome to be here. I totally nerd out on this stuff, so it's fun to come and talk about pain and injury. I think it's super helpful to people. There's a lot of stuff out there, common myths, and just kind of debunking some of that stuff

and then trying to put things out to help people. So it's been cool to see it grow over the years. Yeah, let's get right into it. What are some common pain myths that you'd like to debunk? You know, probably some of the biggest ones that got me started back in the day, I've been a PT for 17 years now, and I you know probably just two to five years of practice I started seeing a lot of unfortunately a lot of medical providers doctors physical therapists chiropractors a lot of us from an educational standpoint come from this

kind of we look at pain we were always taught to look at pain from a very like posture structure biomechanics a very all pain is blamed on the physical body. And, you know, the more your pain science has sort of evolved over the years, and there's people out there that are physical therapists who then go and do PhDs just in pain neuroscience, the more we've learned about pain, we've seen that it really is tied to our mental health, our, our thoughts and emotions, our social connectedness. And I think we're seeing this in a lot of places on social media now, how important those things are in your health.

But that was probably some of the biggest myths is that I'd be frustrated because patients would come in and they'd tell me something that like, oh, this person said my back pain is because my legs aren't the same length. And it was just such, you know, I think in some cases those practitioners were intentionally telling that to people to create this dependency on coming back, you know, because they want to keep their business going.

Shout out to my chiropractor. Yeah, it's like you'd see a lot of that stuff where it's like, oh, I, you know, you create, use fear mongering and it's the opposite of placebo. You use the nocebo to use a narrative that's actually ends up being harmful to people that convinces them they need to come back for your intervention. And that's only what didn't get better. And really the pain neuroscience research as that evolved showed that one, like most things get better just with time, but they're much more complex. Like pain neuroscience, the experience of pain is this complex thing that really emerges from your brain it's it's not something that's in your tissues of your body that's what we i mean you know years and years ago that's how it was thought of like you'd have a pain in your foot that would go up and tell your brain there's pain down there but over time it's changed to where now we see you

can have something happening that's kind of dangerous to your body and you'll have these danger messages but really your brain determines should i output pain and that's kind of dangerous to your body and you'll have these danger messages, but really your brain determines, should I output pain? And that's highly individual. It's based on like how stressed you are, you know, how stressed you are, what's going on in your environment, memories, beliefs, like the culture you grew up in, you know, because pain is viewed, you know, like different cultures look at pain as a weakness. Like sometimes you just don't talk about it. Yeah. So anyways, there was a lot of that stuff. It was like, I really need to, if I'm going to help more people, um, cause you'd have people that just wouldn't get better with like the old ways of thinking. And so it really motivated me to like, I need to go down this road and learn more about pain. And, uh,

that was really where a lot of the social media stuff came from. Yeah. That's so interesting. I always thought of pain as just physical and not mental at all, to be honest. Yep. Yeah. a lot of the social media stuff came from yeah that's so interesting I always thought of pain it's just physical and not mental at all to be honest yep yeah a lot of you would do obviously there are a lot of pains like that you know so now we look at it from this biopsychosocial model so the bio part is the physical test mean like if you sprain your ankle that pain is mostly physical that's what I thought of yeah this is a crazy like 15,000 ankle sprain today in the US yeah so you Jeez. That's a lot. I almost did it yesterday. Yeah, definitely.

Same. 15,000. Yeah. So, you know, if you sprain your ankle, you probably stretch those ligaments on the outside of your ankle, and that's probably going to create pain. So if you have pain in that situation, that is most likely really tied to those physical tissues. Right. But you look at something like chronic low back pain, you know, and there are a there are these different kind of characteristics and ways you can differentiate from sort of like a more mechanical pain to something that has these other factors. So like how long has it been around chronic pains?

You probably heard like fibromyalgia, things like that. They'll kind of spread. They won't be as mechanical in nature. A real mechanical injury, you can kind of turn it on off very easily. Like if you stress that body region or hurt when you stop stressing and it stops hurting. And, uh, but there's a lot of pains that just aren't like that. And so you've got to kind of figure out what type of pain do I have? And that kind of helps you figure out how do I address it? And a lot of chronic pain is actually like the approach to it is kind of like mental health disorders where you expose people to the

threatening thing, but in gradual steps, like if if you're scared of I was bringing up the example if you're scared of snakes rightly you know you're on your first appointment yeah you don't just hand the person a snake you might just have them think about snakes or like watch a movie with us exactly so chronic pain is very similar it's just that it's your movement system that's sensitive so rather than trying to repair fix some tissue in the body, you're just trying to desensitize the nervous system through gradual exposure. What are the most common pains you see and what's been the best solutions in your experience for those pains? Yeah. You know,

for sure. If you look at the stats, some kind of like low back pain, spine pain is just really common. You know, we were just talking about neck pain a second ago. So those two are really prevalent. You know, and then associated with those neck pain a second ago. So those two are really prevalent. You know, and then associated with those, you can have people who just have that pain that stays in their spine. And then they can have radiculopathy where it has a nerve pain that travels down their arm or leg. Whoa. So you have that. I have that because of my SCM is so tight. So I'll get vertigo because your SCM wraps around your ustean tube.

Yep. And so sometimes when I go on a plane, I have to take a muscle relaxer, literally just so that the pressure in my head will release through my use D and two because my SCM is so tight. And then if I stretch this in a weird way for too long, I can feel the tingly all the way down my hand. Exactly. Yeah, it's crazy. Your neck muscles are super tied into the function of like your head. A lot of people with jaw issues and kind of ear issues

have neck issues in combination. And that position you were showing with your arm, that is a very common, we'll actually, with a lot of these nerve pains in rehab, do something called nerve mobilization. Sometimes it's called nerve flossing. Sort of like imagine pulling floss between your teeth. Your nerves move like that.

They do these studies where they will put pins in the nerves of cadavers, and then you move the arms and legs of cadavers. And they found that your nerves actually like that they do these studies where they will put pins in the nerves of cadavers and then you move the arms and legs of cadavers and they found that your nerves actually have to slide from anywhere from a few millimeters up to several centimeters so that position you're talking about if you reach out like that that's actually the primary position we use to um mobilize the median nerve which is my money now yeah so you should do that as an exercise like when you're having like if you get arm tingle like that, what you would do, it kind of looks like this funky dance, but when your arm is out like that, it tensions that median nerve. That's why

you start getting that tingling. So what you do is you alternate. So when you bring your wrist up like that, you move your head away. So now the nerve is tensioned at your neck. Yep. And then when you go the other way, then when you go the other way, it tensions it down towards your wrist and puts it on slack. I can never crack my neck that way really ever which it may be that you know because all those nerve roots are exiting that side of your neck so and going down your arm so if you change the tension on the nerve farther down its path it will influence your spine wow it's kind of crazy and it's not like it sounds like voodoo but they literally study it in cadavers and now we have studies showing like in carpal tunnel that same nerve goes through there your nerves have their own micro circulation

So if you do these nerve mobilizations, it's been shown that it improves circulation to the nerve. So spine pains a big one And then once you get out of that, you know You see a lot of things like you look at shoulder and knee, of course like the ankle sprain thing You know in the knee you see a lot of you you know ACLs get a lot of coverage meniscus tears a lot of people just have just general pain things like a root pain on the front of the knee is super common yeah I have a ton of that I had a surgery on that my kneecap in high school and I just have patellofemoral pain on that side and so if I do too many squats or something, it'll flare up.

I can't squat. I've just got to get this kneecap seven times. Meniscus three times, MCL once. So I want my best friend here to live forever. He's tall. He's always worried about how taller people don't live as long, right? You're not worried about it, but it comes up. It comes up statistically.

What can my homie here do to make sure that as a taller than average person, he does things that maybe, you know, six foot, not five, eleven. Yeah, I said my six foot self doesn't don't have to do that because he's tall. No, it's huge. You know, I think the big thing from like your physical body kind of standpoint for longevity, the biggest thing is honestly like resistance training, you know, because if you keep yourself strong, what happens? You know, it's it's easy when you're like in your twenties and thirties,

but as you cross, like I'm 41 now, you just, as things start to change, I, yeah, luckily genetics, I look good genetics and then maybe hopefully exercise is helping and all that. But, uh, no, you know, you, people lose muscle mass. Like you just lose muscle mass as you age, your bone density goes down. And those are the things in a lot of cases, if you look at mortality, you know, I mean, maybe you had a grandparent like who fell and fractured a hip or something like that. It's those types of issues and people get older and they become frail are a lot of times what end up make causing them to be sedentary. So like somebody falls down, then they have what's called a fear of falling. I mean, it's a really high the number of people that die, older people that die after a

hip fracture. It's like 30 percent die in the next year. Whoa. So it's and a lot of that is associated with muscle weakness leading up to that. So they're already weak. They fall down, then they're scared of falling again. So then they become more sedentary. They become more deconditioned, weak, their bone density drops, their muscle mass drops and they just fall down and then or they get pneumonia because they're sedentary. So I think, you know, when you're taller, you have longer levers. You know, I'm only five, nine. Like you think about Olympic

gymnasts, they don't have like really long levers. You know, they're often very muscly. They show muscle. It's just easier for them to control their body. I think when you meet people, not that it's so much your, maybe a longevity standpoint, but I think taller people, you do see more like back pain. And I think a lot of that often is because they just have this longer thing that their muscles have to control. And again, back pain is really complex. I don't want to blame it on just that. But I think when you're looking at longevity and keeping yourself like living as long as you can, resistance training, like keep yourself strong. If you don't have a,

like just, yeah, it doesn't have to be super complicated. Like you just look at foundational patterns, squats, deadlifts, pressing, pulling, like just keep yourself strong. And as you get older, it'll really make a difference. Yeah. Now what's your stance on chiropractors? Cause my friend works in an ER.

He's actually seen some paralysis. Where do you stand on them? Yeah, I think it's like any profession, of course, there are good and bad. I have a bunch of chiropractor friends, and I think it depends on what school of thought they go through. But I have a lot of chiropractic friends who are very similar to physical therapy. And that's really how we should be, because ultimately, we're both musculoskeletal providers. I think the problem is when you get chiropractors to sort of act like they're mds and we'll say this manipulation is going to cure these systemic things in your body

that stuff's frustrating because there's really no evidence for that um and it's just dishonest if they're trained that way and that's what they believe i mean that's a problem with the education system but they really are musculoskeletal providers they should be treating pain injuries like physical therapists do so there's that side of it the other thing that can bother me about it is the that was talking about in the beginning sometimes i think with chiropractic more than other healthcare professions sometimes you see this tendency to tell people that you have to come back to see me to have this adjustment, you know, yeah. And that just isn't supported. There's this idea that your spinal joints can go out of alignment. Isn't the case. You'd have a fracture. That was true. Like if you look at,

you dissect a human and look at how secure your spine, your vertebrae are in, they don't slip out of place. Your discs don't slip out of place. They're held in place by ligaments. Like that language actually is really harmful to people telling them, oh, you've got a slipped disc. You've got to come here or you've got this x-ray and your neck curve is flattened. I'm going to do this adjustment once a week for the next, you know, six months and that'll fix it. And you do x-rays before and after it doesn't, the curve doesn't change. Wow.

So really rehab should focus around symptoms, pain, and function. So I think those things are frustrating to me too when it's taking advantage of people really just for putting money in your wallet. For money and financial reasons. Not putting their health at the forefront. Every chiropractor is different, but that's what happened to me. I felt like I was at the meat factory because I went in the first time and I felt like the most important person in the world. Here's the x-rays. There's two doctors telling me how they're going to fix me. I felt like I was at the meat factory, right? Because I went in the first time and I felt like the most important person in the world. Here's the x-rays. There's two doctors telling me how they're going to fix me. And then from then on, every time I went, it was one of the associates just giving me a quick little like crack and a crack, not actually adjusting me and sending me on my way.

Yeah. Yeah. That's the stuff that's just total BS that, you know, it just, if somebody wants to pop in, you know, my, when I came out of school, my residency was in manual therapy, which was hands-on, like you're doing massage mobilizations, manipulations, those things do have a place like in the it's short term evidence, you know, they can help kind of jumpstart people and get them out of pain. And I think they're really useful for that. Like you could, I was just talking to my buddy here in town is a jujitsu guy. You know, he strained his neck.

He couldn't turn his neck very well and he went and saw his chiropractor. He was a minute adjusted and he could, he got range of motion. His pain went down. His range of motion is better. That's a great place for that. As long as the narrative is not, you have to keep coming back here to do this, to keep your spine healthy. If it's just, we're going to use this to get your pain knocked down and then you're going to implement exercise and movement, which have the better long-term evidence. Yeah. That should be that, that plan I think is okay. Absolutely Absolutely now I need to know this for my own sake So I have scoliosis. Is it true that bad posture can can cause that or is it genetic? Yeah

More often nowadays scoliosis and things like that are more attributed to genetics, you know I just you'd see less and less in the research of posture being something that we it's less emphasized nowadays. Like you could take people and stick them like this for a year and they could still straighten back out of that position. It's just the idea that adopting some posture is going to permanently deform your spine and cause scoliosis that, you know, because when you adopt a posture, you are using your muscles, right, to change the position of your spine. In a true scoliotic curve that's a structural curve, you know, that the bones are changing shape.

So for you, now, of course, your musculoskeletal system is always adapting. So in theory, if you stuck somebody, like we're going to torture them and put them in a particular spine position, or maybe they just literally through behavior, behaviors held that position for years and years. Maybe in theory, when they were developing from a young age, that could change how the bones develop. And I think that that's why this definitely can happen. Because if you look at kids who, that's why physicians, right?

That's why pediatricians are always checking I have two daughters like every time you go in there they're checking for scoliosis yeah if you catch that early you can put them in a thoracic like say it's in their mid back you can put them in a thoracic brace and that will stop limit the development of it well and so if you slow it at that age their bones won't actually change shape and it will limit the severity of a structural scoliosis. So there's two types. There's functional and structural. People can have functional scoliotic curves where literally just have like a spasm in their low back. You can have a leg length discrepancy. You could have different things that can be changed by

changing your muscles that correct the scoliosis. If you've had a scoliosis for a long time, you probably developed it as you were growing. And, and a lot of people, they're not actually, they don't impair them that much. You know, the, the curves, if they get really severe, they can impair, they can affect your breathing and things, but lower curves, a lot of people have scoliosis, they don't have any pain and it doesn't affect their function. And the people who do often get better with kind of general back pain programs you know so you know I think you know if you again if you're if you're in those really young developmental years and you're always in a particular posture maybe with enough time you could change how your bones and things you know our shape but you know

again that's why they check people and you can use bracing and things like that to prevent it from getting worse is your do you know what your but you know again that's why they check people and you can use bracing and things like that to prevent it from getting worse is your do you know what your angle is is it no I went to the chiropractor and the guy was like you know you have scoliosis right and I haven't been told that since fourth grade so I just I take it take it with a grain of salt like I think don't let that even if it's it's probably if they did actually see something that's valid it's probably a really small curve don't let it get in your head yeah honestly because if it's a small curve and it hasn't been mentioned that long, it probably

is small. And it probably you if it does bother you and maybe it's associated with pain, there's a lot you can do with just general back pain. Yeah. But don't you know, that's the type of that's a message that man to put that in someone someone's head. Yeah, I was upset. I'm not going to lie. I've been told that since I was in fourth grade. So how can that not mess with you like then you start not trusting your body you start feeling like oh do i have a problem you worry about it that actually worry and stress can cause more pain so it's yeah that stuff really bugs me it's all good um so you started off with the massage stuff you said right so what are the best types of massages in your opinion? I think actually it's overcomplicated sometimes, honestly. You know, there's all different kinds of things like active release and, you know, there's

of course like deep tissue, there's kind of lighter type massages. I think it really, if you're looking at it from a like health, like a pain standpoint, I mean, of course, if you just like feel great and you just want to go do a feel good massage, then just base it on what feels good to you. If you're looking at pain and injury, then it also is kind of the same where you're trying to, when someone has pain, you're basically trying to calm their nervous system down. And so soft tissue work like massage is a good way. Your skin has a lot of receptors, a lot of nerve endings. So it's a great way to kind of tap into that person's nervous system.

And you're basically trying to grade the pressure according to what their brain perceives as threatening so you don't ever these old back in the day we used to just push on everyone really hard we just do this really intense deep tissue kind of massage and thought oh this is just good even if they're crying it's good right it's going to break some you know there was this old idea that you're breaking up adhesions you've got muscle knots you've got to break them up that, a lot of it's been debunked with ultrasound. They basically, people just, when they fill a tight spot in a muscle, a lot of times it's now just thought to be a hypersensitivity in their nervous system because you can't see it on

ultrasound. So there's nothing really there. That's crazy. But they feel like something. Because you feel a knot sometimes. So that's not actually there. Now, sometimes what you feel when you feel a knot, because there are a lot of muscles that are just naturally anatomically are very ropey. And so people will be told that's not actually there now sometimes what you feel when you feel a knot because there are a lot of muscles that are just naturally anatomically are very ropey and so people will be told that's a knot when it's actually just the architecture of the muscle so a really good one is your levator scapulae muscle which a lot of people will be like oh i'm sore right here right here yeah yeah like i have yeah it runs at an angle goes up into your neck and so if you if you go like this you will feel it you can strum across it and it'll feel like a bump and people will be like

oh i was told this is a knot and i got to work that knot out. That's literally just the anatomy of your levator. So there's a lot of muscles like that where that muscle is just, it's only about this wide. So of course it's normal anatomy. If you just go like this, you're going to fill the edges of it. And so, and it's often a spot where people do hold tension and we'll have these kinds of trigger points. But if you look at it under ultrasound, there's nothing there. It just feels tender when you push on it. Interesting. So yeah, there's a lot of, you gotta be careful.

That's another one of those things like, oh, you've got this knot here and we've got to release it. That spot, the way it feels, isn't gonna change. I mean, you have to cut the muscle out if you wanna change it. So a lot of people crack their fingers, crack their back, crack their necks. Is that actually good for you or

it uh that yeah yeah right everyone everyone i think everyone's parents told them oh you're gonna it's gonna mess up your joints or whatever you're gonna get arthritis that's been pretty much debunked there's actually a cool study where a guy he did imaging on his hand knuckles and then he popped one hand for years and years and not the other and then he did imaging again and he won a big award but it didn't change because joints are the same. And if you think about it, when you go in to see a practitioner and they adjust or manipulate your spine, they're literally popping your facet joints in your spine, which are about the size of your knuckles.

So they're literally doing the thing that your parents told you not to do to your hand. They're doing it to you for a treatment. Wow. So yeah, it's been pretty much debunked that that kind of, even if you're popping yourself, it doesn't seem to damage anything. And it appears that it's just this pressure released in the joint. And if you have pain, it's another one of those things where it gives this kind of quick impulse into the nervous system and it can temporarily give people reduction in pain and improve their mobility. Nice. So yeah, I just did it. Yeah. I tell people,

you know, I mean you, it doesn't seem like there's anything harmful from it. I think sometimes if you're feeling the need to do that all the time, you might want to have assess like, why is it an anxiety type of thing? Are you feeling, is there like a sort of, like say you're doing it in your neck. I went through a period of time where I did that all the time, my neck. And I think it was funny. I think some of it was just a habit where because I popped it, I got in the groove of just popping it and it just became a habit. I didn't really need to do it. And then once I stopped it, it was funny i think someone was just a habit where because i popped it i got in the groove of just popping it and it just became a habit i didn't really need to do it and then once i stopped it it was harder to pop it again if you're feeling muscle tension all the time because some people will get that where they have a lot of muscle tension and then they feel the need they

self-pop and it feels better and maybe if that's chronically happening maybe there's something else you could add that could prevent that from coming back as much maybe it's like even strengthening exercises are kind of interesting when people feel tight right we'd always do massage and stretching there's been some kind of new research looking at actually when you activate a muscle and strengthen it sometimes that works better for people to get it to relax which is counter to because you think about contracting it it's getting tighter but there's some people that when you you know if you ever felt that like you stretch in the morning you contract all your muscles and stretch and then

you feel like everything's relaxed yeah it's kind of the same phenomenon that they do this a neck pain and people get it at work that they'll have them do these resistance training like strengthening exercises a lot of those people will get better with that versus a stretching program wow wow that's crazy i would have never thought of that yeah yeah it's cool it's cool to see the science change like how much it's changed uh even since I got out of school in 2007, just how different, I think just how complex the body is and the nervous system. And, but at the same time, the stuff you do for it to keep it healthy, it doesn't have to be that complicated. You know, it's like, if you've got mobility problems, you work on mobility and

otherwise you just try to keep getting strong, keep strong. Do you think that our healthcare system can or will ever get to a point where it's more of the preventative stuff that you're talking about instead of just take this pill and you'll feel better? Man, I'd like to think it would. I left insurance a long time ago because of the frustrations with it. And it just seems like it's getting worse. Yeah. You know, so many PTs are just burnt out.

They're seeing 15 to 30 people a day and 15-minute sessions. You just can't get people better. And yeah, they're just the idea that it would shift. I mean, it makes so much sense. Like to have people come in before they have symptoms and teach them or even to have insurance reimbursed for personal training. Like to pay for that would make a ton of sense. Like, hey, we'll pay for you to go work out a few times a week with a trainer. The number of issues it could cut down on really so many people just are sedentary

and there's so much research now on exercise and its ability to not only keep you strong and mobile, which will reduce injury risk, but reduce inflammation in the body. I mean, so many chronic diseases now are related to inflammation, right? Chronic inflammation and exercise is one of the most powerful things you can do to reduce inflammation. And so insurance companies, I just don't know. It seems so unlikely to me that it'll happen anytime soon that they would pull the trigger to do that. But it makes, you know, it makes so much sense. Yeah. What are you working on now? Anything exciting? Yeah. I mean, it's just, um, I've got the book out of course. And the book is, um, a big one, like we were talking about, it's almost 500 pages, but it was kind of bringing together

because, you know, on social media, you can only kind of touch on things. It's just, and people can't find stuff. People ask me all the time, Hey, do you have a meniscus post? And I'm trying to send things and they're not that comprehensive. It's just a few exercises and it's cool to see that help people. But the idea with the book was to create this resource for the whole body that has programs, you know, pictures of me doing exercises where you can basically, I can go to the elbow chapter and find a tennis elbow program, or I can go to the foot chapter and find a plantar fasciitis program or any part of the body and, uh, just spell things out in more detail. The cool thing is because there is so

much evidence for education and exercise, those are things you have control over. So you might have a problem where you go see someone for a couple of manual therapy visits, like it's really bad. You go get an adjustment or whatever, but then you go back to your exercise and movement that keeps you healthy in the longterm and learning about pain. That's the education part. You really, we know in the research that if you learn about pain, you, people are less anxious about it. And actually their pain symptoms tend to be worse. It calms them down. You know, it's just anything that's, I think anything in life that's unknown is more threatening to us, right? It's scarier if you don't know anything about it. And pain is that way when people have pain, they get all these

kind of worries and stresses. So a lot of it right now has been doing awesome things like this, like coming to podcasts and meeting cool people and talking about the book. And, you know, just that's kind of the focus right now. And probably what we'll do is I was just my co-author lives here in Vegas. So I was talking with him this morning and we'll probably create smaller because the book is big and covers a whole body in a whole box. You can use it as your dumbbell. Yeah, I'll check it out. Yeah, it's a great book. I whole box you can use it as your dumbbell yeah i'll check it out yeah it's a great book i like how you have photos because i'm very visual yeah and i feel like reading that wouldn't wouldn't make sense it'd be hard to understand yeah i think the photos most people were excited about those programs you know i hope they'll go back and read some of the pain and

injury science stuff but uh most people were really excited just to have the programs and kind of a d it's kind of a DIY self-guided rehab book. So, you know, we'll create smaller ones, I think kind of paperback smaller ones for each joint region if case people just want one region and, you know, eventually kind of branch into there's a lot of practitioners, you know, a lot of people who follow my account are located internationally and are practitioners where physical therapy education is 20 years behind the U.S. Right. And so that's the really cool thing about technology is just having these platforms where you can spread education other parts of the world.

And it elevates health care across the world. So I think having courses for those, you know, those people that go into more depth will be another kind of branch of this. But it's all been kind of a new journey for me. I was practicing PT and teaching at a college. And it really, social media was just a hobby. So now it's kind of this whole thing of transitioning into it being a real business and the book's kind of a launching point. Love it, man. Tom, where can people find out more about you? Yeah, it's a at rehab science on, uh, uh, Instagram and YouTube primarily. Um,

and then the book is called rehab science, how to overcome pain and heal from injuries on Amazon and Barnes & Noble and any people can always DM me if they have questions about stuff or looking for posts on things so but yeah that's it and thanks for having us awesome yeah so much man thanks for watching guys I'll see you next time