In Your Pants with Dr. Susie G - Moving Beyond Pain w/ Ben Cormack

Episode Date: January 24, 2019

Hangnails hurt like hell, don't they? Just because it hurts, doesn't mean it's life-threatening. Let me take it a step further by saying, hurt doesn't always equal harm. Today's show expands on this topic of pain, how it changes your life, and what you can do to move beyond pain. Ben Cormack owns and runs Cor-Kinetic. He is a musculoskeletal therapist with a clinical background in sports therapy, rehabilitation, pain science & exercise stretching back 15 years. He specializes in a movement & exercise-based approach with a strong education component and patient-centered focus. Ben is a popular international presenter who has delivered conferences presentations and courses all over the world.

You're listening to In Your Pants with Dr. Susie G, the physiotherapist for your private, helping you get in the know down below. Hey guys, it's Dr. Susie G here and welcome to the In Your Pants podcast, a show where we talk about the issues in your undercarriage so that you can keep embarrassing search histories off your browser. On today's show, we're going to debunk some of the most commonly believed myths around pain, and how you can cultivate resilience even with stressful circumstances that pop up in your life. This is a pretty big topic that needs some big shoes to fill, and since I'm only a size 5,

I've asked Ben Cormack to help me out for this episode. Ben Cormack owns and runs Core Kinetic. He is a musculoskeletal therapist with a clinical background in sports therapy, rehabilitation, pain science, and exercise stretching back 15 years. He specializes in a movement and exercise-based approach with a strong education component and patient-centered focus. Ben is a popular international presenter who has delivered conferences, presentations, and courses all over the world. So without further ado, I hope you guys really enjoy today's episode. Thanks for listening. Hey Ben, thanks so much for being on the show today. I'm so excited to be talking to you about some important topics, pain, resiliency, all sorts of

fun stuff. Hey Susie, thank you for inviting me. Hopefully we can get into some of those topics and I can shed some light on some of those for people. Your stuff is really good, by the way. I've been following you for quite some time and you're just putting it out there, being transparent, being real with people and practitioners. And I just have to say thanks for doing that because to take some balls or bollocks. I like that. Yes. The proper English cultural reference is not balls. It's bollocks. That is very, very true. Yeah, no worries. Okay, Ben. So let's start diving right in with this question of what are some common myths that people have about pain? I think if we're going to think about pain, firstly, you know, we have to understand that

pain is it's a really really unique experience so um with that being said um there are still probably some some things that people kind of believe about pain that maybe aren't always accurate and this is one of the wonderful things that we have with science and and data and research is that we're able to kind of test a lot of these things and just kind of understand more about pain in general so i think the biggest um myth and maybe it's not a really it maybe it's not a myth per se but one of the things that we know about pain is that pain doesn't always equal damage or if we wanted to say it in another way we could say hurt doesn't always equal harm so i think a lot of the patients that i see will think you know because their back hurts or because their

foot hurts or because their knee hurts that there has to be some kind of awful damage going on and And the more pain that they get, the more this damage is occurring or is getting worse, you know, whether that be kind of it's inflamed or it's ripped or it's torn or it's degenerating. And one of the things that modern understanding of pain has taught us is that pain and the amount it hurts and the actual state of our bodies don't have a really, really good correlation. If we go back, you know, hundreds of years, there's a really famous diagram by Descartes with a boy who sticks his foot in a fire and then that kind of, you know, that signal travels up his brain and then he feels pain, you know, and in a way that's partly how it works. But we know there are lots of very, very painful scenarios that don't actually correlate very well with the state of our bodies. And, you know, we might have an example, something like an ice cream headache, where you eat ice cream way too quickly. And then suddenly it feels like you're going to have brain hemorrhage. But we know that, you know, you know, you're not going to have a brain hemorrhage experience teaches us that.

Although there's a couple of times I think with ice cream, it's been a bit touch and go for me. you know i've just been reaching for the phone to dial to dial the emergency but i just backed off in the states we call it the brain freeze the brain freeze yeah brain freeze so i didn't we do 999 not 911 so maybe that's what saved me um and then another great example would be a hangnail i don't know if you've ever bitten your nail you know you think i'm gonna get that sucker oh yeah and you start biting away and you bite a little bit too vigorously um and then suddenly you know you're left with that little bit of nail that is just absolutely just you know agony and again that's really not going to kill you i promise i mean again there are you know maybe my wife she

can be uh you know a bit neurotic so she she might think she's dying from that but certainly uh it can be pretty it can be pretty painful but it's not going to kill you i can promise um and then probably the most um the best example is stepping on children's toys for anyone who's got anyone who's got children you know stepping on their toys or you know if you've got nieces or or nephews and um the pain from stepping on toy soldiers or or stepping on lego or something is phenomenal you know this is real eye-entering stuff but but again no one has ever died from stepping on lego i've searched the annals of medical history for anyone who may have died stepping on lego but I don't know of any so there's going to be someone somewhere um and actually the wonderful

story my son I watched my son step on his own lego the other day and it was like a divine moment where God just came down and just you know meted out his punishment for years of me stepping on his toys so that was that was a wonderful moment for me but you know there are lots of examples where we can have a whole bunch of pain but we don't have a really really good correlation with the damage that happens within our body you know and there's other examples where people get blown up on battlefields you know there's some research into this in the second world war um and you know they've got massive injuries but guess what you know the pain that they experience is quite minimal so um you know lots of examples where hurt and harm don't really correlate so if we

took something like back pain for example back pain can be really really painful you know it can be eye-wateringly painful but the the majority of back pain is not medically serious you know you have nothing damaged there's nothing serious wrong um but it can be really really painful and it can really piss you off and it can really interfere with your life but that doesn't mean that your back is falling apart and it doesn't mean you're going to be disabled forever the majority of back pain kind of you know goes in in kind of two to six weeks so so i think that's really important to remember and ben what do you say to those people who just don't know well how do i know it's nothing more serious you know put their mind at ease because they're thinking that

there is something more serious going on um what do you what do you say like how do you differentiate between okay well this is just pain that's going to come and go versus maybe i should get it checked out yeah at what point yeah i mean that's a really really interesting one just simply because I would never tell anyone, you know, simply for good medical advice's sake, it's very difficult to tell someone to ignore pain. And if you are ever experiencing pain and you feel that you should have it checked out, then you should go and get it checked out. You know, I think that's important to point out. But certainly, I think if you have a good quality professional, what you're working with, you know, physical therapists, physiotherapists, osteopaths, chiropractors, whatever, you know they're going to be able to determine whether um whether that is serious um i think

what we do know is that the vast vast majority let's take back pain for example the vast vast majority of back pain we know isn't medically serious in fact one percent is medically serious where it's a real big problem and then about 10 percent um is related to things like nerves or nerve roots and even then that's that's painful i don't know if i would determine that as serious and then you we have about 90 which is we can't really determine the cause and the majority of it responds really really well um to treatment so you know i think it's important to kind of know your body to listen to your body um and since have i felt this before you know so much of back pain is recurrent it happens quite regularly and experience often tells people

you know whether whether they've been able to manage it previously whether whether they've that's been a big problem in the past but certainly if you're ever worried about pain i'd always advise you to go and get it checked out um just make sure that you do that with someone who is uh who's smart and who knows about the modern science of both pain and and and kind of back pain for example and that's the trick that i have found is very difficult and that does not happen often no well this is so so true you know one of the big problems with health care is the business of health care and the and and people in health care sometimes and you know i think one of the big issues is that we have lots and lots of new information research data science about pain

and injury coming out all the time and we've even got you know over the past 10 or 15 years we've got new paradigms of understanding you know or we've increased our our breadth of things like knowledge of pain within we've started to utilize things like the biopsychosocial model more and we understand it to be so much more than just nerves and bones and tendons and ligaments you know pain is about people unfortunately this sometimes trick takes time to trickle into health care And there's still a lot of health care that's quite dominant around our previous model, which was far more structural and about injuries and damage to the body. But we just know from research and we know from modern science that this is just not the case, that we should be moving beyond that. But as you say, sometimes it's a bit of a lottery or a hit or miss for the kind of practitioners that you might come across.

And that's unfortunate, isn't it? Right. It is very unfortunate because there's a lot of rabbit holes that one can go down, which only perpetuates them in the current state that they're in and further helplessness and hopelessness and frustration and anger. so yeah I mean this is the real I mean you just said some fantastic words there you know helplessness and you know these kind of things and I think if I was going to talk to anyone in pain I think what I really want to talk to people about is how pain makes us feel not just on how much it hurts but how much it changes our lives and I think that's the biggest thing that we need to get across to people in pain that it's okay to feel down that pain has these effects on our circle of life and our friendships and our work life and our families and things like that so

the biggest thing about pain for me actually in a modern view of pain is moving beyond pain and it's understanding people in pain and the effect of pain on people's lives for me that's that's really really important you know so one of the problems is is even a lot of the discussion that we have around pain is still very pain focused that we need to really start to understand people in pain and the effect that pain has on lives not just the sensation of pain or is it linked to damage and these kind of things and I think hopefully over the next 10 or 15 years that's where we're going now it's not just the science of pain from a sensory perspective and how it feels it's the science of pain from how much it impacts on people's lives and I've got a kind of a saying

the more we understand about pain the less it teaches us to focus on pain I think that's awesome so true very true and i'm just going to ask this question because i had this asked to me by a person um you know we're going through and you're talking and you're giving them not just talking but you're trying to get to know the individual and they kind of look at you and they're like well a lot of people think that you're wrong and you're like hmm how do i answer that and I didn't know I said you're right I I I have the potentiality of being wrong that is so true you know so I mean what how would you respond to someone kind of saying like well there's a lot of people who think you're wrong in terms of I mean yes I mean there's a bundle of people that

think I'm wrong as well I mean there's probably more people who think I'm wrong than right by a magnitude of quite a few right when you say wrong you mean in the way that we're looking at pain correct yes exactly and and again this is one of the things that i discuss and teach with people i teach to my students quite regularly is that why should people believe you if you've been if you've had all this information perpetuated to to you by a health care system if you've read books and you've looked at the internet which is dangerous within its own right i just wanted to add that oh yeah if you've been to see a number of different doctors and physios and whatever and they've all been talking about the same stuff it's your back it's related to this it's your this

it's your that it's your other and then someone comes along little ben or little suzy and they say well do you know what i've got a different take on this i've got a different view here you know what these these people maybe they are thinking about things from a previous paradigm maybe they're not up to date enough but if 10 people have said it to you why should one person why should one person kind of make a difference and i think that's an important point that the weight of evidence and information is actually on the side of um the kind of traditional view of pain because this is you know this is what's perpetuated by the healthcare system and by doctors and surgeons quite often because actually our understanding and teaching about pain is very

very minimal you know in certainly my education about pain was very very minimal on an undergrad and even a post-grad level yeah likewise so you know actually people who work with people in pain don't learn a lot about pain which is quite i always liken that to a mechanic who doesn't really know very much about engines or isn't very good at fixing your brakes because what's your key number one subject it's like people in pain and we don't learn anything about people and we don't learn anything about pain so you know i'm thinking what the hell are we learning about but anyway for me actually what i always like to do is i like to talk to people about their history um simply that you know a lot of people have followed a paradigm of wanting to get fixed and

they want someone to be able to provide a magic answer or a magic operation or a magic pill and often you see in their medical history that there's so much of this kind of um you know a patient said this to me the other day of a dog chasing its tail which i thought was very profound um you know there's all this tail chasing and looking for this off switch and finding the cure and if you keep going around in these circles and you're not finding the answer then you should at least give someone who's got a different answer at the time of day you know a lot of it is often in the fact of well the reason i might be less wrong is because what you've done so far certainly isn't right you know it might be that going down these roads hasn't been beneficial for you and

you're uh and and maybe trying something different might be beneficial you can't guarantee it but certainly it might be different and so i can't guarantee that i'm any less wrong but i might be able to offer you a different path that might get you a different result right absolutely and and that's just it it's you know stop stop teaching the tale it hasn't been working and sometimes you have to point it out to them too i feel like because they just don't realize that they're in this whirlwind of a mess and and and they're not seen clearly because you know when we're in pain and in distress and frustrated you're really not using your you know higher cortical parts of your brain that are decision making and self-regulation i mean you're really

just automatic and trying to get help because it's such a survival-based threat i mean it's just a threat in your world in your life i think if your entire day is taken up by pain and worrying about pain worrying about the future I don't know if you've got a lot of mental energy left for doing other stuff and you know when we delve into the the pain literature we see that pain has an effect on as I said before people's lives in such a profound way that's because they may be worried about getting pain when they go and do something with their friends on a night out it may be because they don't want to play sport or do the things they used to do because they don't want to flare their back up for three days and in between all this worry and this stress

the brain energy left is probably quite limited you know so we know that people who have long-term pain issues have less flexibility of thought they have less ability to identify resources that might be helpful for them so from my perspective as a therapist it's about being a coach it's about being a guide it's about pointing out sometimes where we could have a better understanding of what's happening to us we could have a better understanding of the available options that are open to us we can have someone that's there to help and guide us and and discuss decisions that might affect our lives and that's the whole point of seeking help in pain is to get someone actually you can hopefully battle through some of that with you and is able to highlight some of these

things that you are struggling to to work out and struggling maybe to know who's right and who is wrong and you know it's about building trust it's about um just two people trying to work through um to find a solution for you and i think that's important to find that person that coach and that's kind of the person that i've always tried to be i'm not the best you know diagnostics guy and i'm not the best manual therapist but i would like to think that i'm um quite good at being with people and listening to people and trying to coach people to find a different way forward Yeah, that's great. And you're right. You're coaching them and really kind of showing them there is life beyond pain. You may still have these symptoms and moving away from symptomology and symptom relief, right? Going back to life and being with your friends and, you know, being with your children or going to work or whatever that is that you see life fulfilling you and bringing you back joy. I think that's the first thing that should be on the table and not the symptomology per se,

because that all will, you know, once you get back to living, you know, the hope is for that pain just to go away. Yeah. The chase, I think so many people and so many therapists get stuck in chasing pain and, you know, they're chasing a change in their pain. And for me, the first thing is to, you know, just to kind of think about who is this person I'm working with, what's it all about for them and maybe coming to a point of it you know we might call that acceptance is that you're getting to a point of we're going to accept that you know i'm not going to switch your pain off and that we're going to have to think about what you need to get back to doing how can we help you with that and that actually getting people back to doing things may be the

first step in pain going away you know rather than pain going away before you get back to doing right right i don't want it to sound like it's too easy because it's it's not it's not easy it's a process it and it takes a lot of looking into which i think it's hard for all of us when we're faced with a difficult situation in our life whether it's pain or something else but to look in and to really critique our mind and critique our world it's really hard to face those things sometimes well yeah absolutely some you know it's um i think we often need help to turn inwards you know i don't think any of us are very very good at objective self-appraisal you know otherwise there wouldn't be things like psychotherapy there wouldn't be this there wouldn't be that

you know and sometimes people doing it to us who are too close to us husbands or you know family and stuff that can sometimes feel like criticism and attack so i think it's good to have someone who's objective who can actually give you a non-judgmental objective non-emotional kind of help sometimes to look at ourselves and look at our lives and maybe help us just understand what is really important to us and why have we not been doing this you know it's it's self-appraisal it's like the hardest thing in the world and not just tax self-appraisal you know that's really difficult um that that yeah um so you know but self-appraisal is a really really difficult thing and and i think that being able to i've got actually you know i'll i'll give you a kind of

a little personal story my son is seven and i've actually i see some things in him that are very much like me and it's a bit like looking in a mirror and i've got a lot better in the last year at looking at these things because i'm kind of faced with them does that make sense bits of his behavior and i think you know god that's the kind of thing that i do and that makes me think oh well maybe i could think about that a little bit but without something that allows us to reflect um you know it's very very difficult to reflect and i think that's again the role of a good therapist certainly for someone who's got a lot of persistent pain is a good therapist who can you know uh help people not look inward not it's not about self

appraisal from a negative perspective it's more just looking at life what have you stopped doing what do you want to get back to doing and then finding a journey to get there absolutely and this brings me into the follow-up question to that because you had a great article about resilience and you mentioned that working through pain requires resilience so i think this is a good point to bring up right now in the discussion of you know how do you can you elaborate that for us and what does it mean to be resilient in the face of pain or challenge or difficulty yeah so resilience is the kind of ability to keep going in stressful circumstances and interestingly the terminology they use in the in the literature is in in spite of or despite stressful circumstances

but a friend of mine we were chatting the other day and she said well why why in spite of why not just with so learning that you know actually the with might be pain pain's a very stressful circumstance so actually being able to carry on with things in your life even though you have pain so you're able to do it with pain you understand pain is there it's affecting you and you're going to work with it you're going to you know deal with it and you're going to kind of get on with it although it's you know again i make that sound really really simple that's not my own um it's not simple at all by any stretch of the imagination but certainly is resilience is the ability to just you know keep doing the things that you enjoy and it's actually typified by being able to maintain

engagement in cherished activities or valued activities so if you've got things that you enjoy doing if you can still do them even though you have some pain then you are going to be winning at the pain game it doesn't mean that you're going to get rid of your pain but at least you have a quality of life and at least you're not disabled by your pain so pain is one thing suffering is another and sometimes it's about working with someone who can let you know that that pain doesn't mean that your body is falling apart and it's damaged it might just be that parts of your nervous system are a little bit more upregulated or a bit more sensitized than they used to be but that that isn't gonna kind of you know leave you in a wheelchair and you know you can carry on

and you can do these things and it takes hard work and it takes resilience but you can do it and the benefits from that are going to be really really important for you and in fact if you look at something like acute back pain we know that nothing works for acute back pain it's going to be there not a lot makes a difference it's going to be painful for a bit so I think the people that often go from having acute back pain to more persisting back pain are those that maybe stop engaging in things that they enjoy catastrophizing looking at life as something that you know is problematic now that these problems are going to last a long time into the future that they need to find someone to fix them these are all the things that actually are prognostic for back pain

having a worse outcome at one two five year follow-up so it's really really important that people if you have pain whether that be persisting first time that we understand that you know the best thing is really to still engage in things that it is emotional it is upsetting it is distressing but the more we let that affect us then generally the more these big things become problematic absolutely and it's that message early on and that's where we talked about that earlier about what provider do they go see it's like winning the lottery they can either have a really good message you know it it really is and that's my take on it the sooner you can get quality information or they can get you know the internet is a a dark place but if you know your research

it's a dark place but it can be used for a lot of good because that's you know where everybody gets their most people get their information from these days but if you know how to get your research and get quality stuff then it could really help you but we know that's almost very slim when you start searching yeah on the internet it's like a gay it's like a seesaw isn't it you're going to find yeah the best information ever on the internet and you're literally going to find the worst information ever and part of the problem is how do people determine what is good and what is bad it's almost it's almost impossible and i think that's a really sad indictment on a lot of healthcare to be honest that it's a lottery that you just don't know what what information you're

going to get but kudos i've got to give kudos to the people like the um the the kind of nhs in the uk and i i see some really really fantastic work being done you know by by things like the physio associations looking at um good information around back pain and and things getting out into the you know the australians are doing some fantastic stuff getting information into the papers some of the big australian researchers doing big public health research stuff you know so there is some fantastic work going on i'll tell you where the big problem is it's health care and money unfortunately that's where we get into that's where we get into the big problems maybe that that's one of the bonuses about having things like a national health system um is actually

sometimes things aren't always driven um in the in the same way economically and maybe that makes it easier to have information that doesn't compete with financial gain potentially oh that's that's a whole other topic for another podcast i think yeah that's right that's right well we'll segue from that because i think you we mentioned a lot of okay you know you have this pain but you got you know, keep let's, what can you still do to, to be meaningful and purposeful in your life? And in one of your videos, it's almost been a year ago, but you asked a great question about, you know, um, should exercise hurt? I thought it was really a good point to bring up for, for the listeners too, is all right. So they are in pain and you're doing an exercise regimen with

either a physio or a trainer or whatever, but you know, how, how much should it hurt? When do you push through and when do you kind of back off so i think really importantly is learning about your own body so i i think that you know it's it you know there's a blanket question isn't it is painful exercise bad for you now if we were to take that from a research perspective we know that performing painful exercise up to about five out of ten doesn't seem to have any worse outcomes than exercising without pain um so from that perspective on a research level we actually know that painful exercise doesn't damage you more that that hurt doesn't equal harm i think that's important from a personal perspective we know that everyone doesn't fit neatly into into an anova or some kind

of you know statistical analysis so we know that n equals one is an important factor which just means you are an individual research doesn't simply tell you about you so certainly these my perspective would be firstly it's a learning game everyone has flared up one of their problems by exercising or doing a physical activity too much but the vast majority of time it settles in 24 to 48 hours i have an analogy that i use for it it's like sunburn so what people will believe is if you have pain if you get pain during exercise oh my god you should avoid exercise it's bad for you well i get sunburned i don't avoid the sun for the rest of my life and they're exactly the same so i have too much exercise i flare my back up i have too much sun i flare my skin up

you know they are just they're very very similar scenarios um they're just a problem of dosing i had too much sun i had too much exercise it doesn't make them good or bad it just means that i've had too much of it um and what do we do with it with you know sun tanning i'm a good brit so i get burnt when i go on holiday you know i um i well you know genetically we are more predisposed to burning aren't we at least i'm not irish or scottish they get burnt more than i do um so i've got a lot of scottish friends it's fine um and you know genetically we are more predisposed though aren't we some people to burning right so if you're black then you are um you know you genetically you are predisposed to not burn as much and it's the same with exercise

some of us are more robust i couldn't run a triathlon but some people some people have that genetic ability to you know run marathons and run triathlons um so we are sometimes genetically more sensitive to exercise that again it doesn't mean that there's damage or harm it might just mean that it's to flare me up but i would say that flare-ups from exercise are normal um i would leave it to calm down for a few days and i would go back out and i try doing something um not quite as rough or as hard um or maybe reduce the dosage which might be intensity or it might be the duration that i do it for or it might be the weight of the exercise or something like that um when i wouldn't push through is if actually it's like i've gone from a two out of ten to a

ten out of ten i would say you probably shouldn't push through then and if you're if the pain is rising continually so 24 hours it hurts 48 hours it hurts more 72 hours it hurts even more so if we're actually getting pain that's reducing over time periods from the exercise then i'd probably you say it's flared up a little bit it's coming back down but we need to also determine a little bit about also we need to determine is it exercise soreness or is it actually pain and i think again that's a learning process because if you exercise people say to me oh my god i felt that exercise in my back and i'm like of course you did it's a back exercise if you exercised your arm where would you feeling your arm so we have this you know it's okay to feel my bicep getting swollen pumped

but if i feel my back when i exercise that's not right well of course it's the same your back and your bicep are you know they're part of your body they respond in exercise very very similarly so you know getting to know your body and learning is important and that's why the sunburn analogy is so important because it's really about uh understanding it's a dosage problem not a problem of exercise or not exercising right oh i know the sunburn i was gardening and a little foolish of not covering up and completely burned my back so it didn't hurt though it was just charred nicely in one area another great example when you get sunburned have you ever been in the shower oh yeah and it hurts oh yeah yes but you're not more damaged no so you have more pain but

there is no more damage the sunburn is exactly the same as it was before you know so there's another example of when you can have more pain but actually it's not more damage it's just more sensitized yeah that's a great example i love it i use it often it's really good um so for anyone who's listening and who's in pain right now let's just summarize i think the top three things you would suggest to them to help them along their recovery what are what are some things you would your top three faves so yeah for someone who's in so i think there are a number of key traits that i see from people and i've read about in the literature and i think they go quite well together um first one is I think we need a level of optimism right so I think optimism is really

really important without optimism why would you go to the gym why would you get out there and do stuff you know I think that's really really important that we remain an element of optimism and what I don't want to come across as is like the guy who's saying just cheer up what's wrong with you put a smile on your face stop turn that frown upside down or whatever you know right and then you just want to smack them in the head right exactly let me smash your face in i don't want to be that guy right so that's i don't want to be that guy so um it's important that we don't minimize people experience you know it's like someone who's obese it's like just saying oh my god just stop eating or if you're stressed chill out man the key here is you know

that it's difficult but optimism and hope for the future are often what drive people to recover that's such a key that you know i've worked with a couple of people along the way in the last 15 18 years and i haven't helped everyone and mostly i i don't actually help people they help themselves but i would say the people that get better go to some pretty dark horrible places but they come out the other side and what they're really looking at is optimism they're understanding that there are important things in their life that they need to get back to and they recognize that and they're willing to work towards that and that's important um so the second point i would say is not looking for someone to fix you so the first point is optimism right be having an element

of optimism so the second point is actually understanding that you need to be an active part of your own recovery you're not looking for someone to operate you're not looking for someone to give you the magic pill you're not looking for someone to put things back into place you're looking for someone to coach and guide you who gives who makes you the star player who puts you in control and just helps you identify those things that you need to do um so it's not about someone fixing you we have really good data on that the people who seek passive care um for their problems tend to have worse outcomes so the more you believe in yourself that that you are gonna kind of get better and you're involved in your you should be involved in your own recovery directly

i would say the more likely you are to recover so that that i would say um i would say they're probably my my two key points you know it's about you um both your optimism and um and seeing yourself as a star player and a key part and also one more thing would just be to really think about your life and identify some things that you want to get back to doing so many people with long-term pain problems i find lack direction in terms of what do they really want to get out of pain for because they've had it for so long they've stopped doing so many things and they almost don't know where to go anymore and what to do so it's identifying that gives us goals and that gives us motivation you know going to see a physio or a sports therapist or a chiro or whatever

you know doing their exercise it's like why should i do this boring exercise what's it going to do for me you know it's really about identifying what are these key things you want to go get back to doing and as a therapist it's my job to identify how we're going to get there how i'm going to cross that bridge between what you want to get back to doing and the things that i need you to do and so it's me i'm planning the journey and i'm going to be your coach i'm going to be your guide i'm going to be your cheerleader i'm going to be your um you know who was batman's friend what was his name robin alfred alfred oh alfred because alfred was the guy who looked after batman right forget robin i think i stole that i think that was my friend roderick actually who said that so

that's a really good one that you know you want to be i'm your alfred you're batman you know i'm here to guide you that's what it's really about so you need to find someone you trust you need to find someone you have faith in you need to find someone with the ability not just to get you in the door and out the door in five minutes with a stretch or an exercise you know you need more than that and you deserve more than that unfortunately health care isn't set up like that because it's not designed around people right right it's insurance therapy yes exactly but the problem with health care it's sad but we're changing one we're doing it in our offices with our patients with our clients with the time we're doing it that's right that's totally right oh my

gosh ben this has been just phenomenal i'm so thankful that and grateful that you have been you're on the show and sharing your wisdom and knowledge with all of us and just helping everyone through a difficult time and um thank you so much for that and for being on the show thank you it's a pleasure so where can listeners connect with you so i've got a website www.core kinetic.com c-o-r hyphen k-i-n-e-t-i-c.com and i've got a blog and we do a little podcast and generally i just waffle away in cyberspace quite a lot and sometimes people hate me for it sometimes people like me for it um but you know i can't win them all no i i i would say i win one out of ten but i'm all right with that ratio it's a good ratio it's one it's the old way you never you

you know you you miss you miss 100 of the shots you don't take right so that's right there you i'm full of i'm reading a book of motivational quotes right now i'm not that was a joke oh i was gonna say what kind of book is that you're on a roll motivational quotes that's cool cool so your website podcast a blog which is an exceptional blog you're also on twitter right and instagram i do a bit of twittering instagramming i you know oh, I'm a cyber junkie. I'm a stalker, so. Well, not anymore.

I suppose you don't have to be surreptitious to be a stalker, do you? You can be quite blatant, so. Yeah, no, it's fine. I think they're called friends, aren't they? Stalkers in cyberspace.

That's right. That's right. I love it. We've just brought it out into the open, haven't we? You know, it's fine. Well, we're making it official now.

You've got to love it. I love it, Ben. Well, again, thank you so much. This has been a blast. And for all our listeners out there, thank you so much for listening to the In Your Pants podcast. This is Dr. Susie G in loving wellness for your pelvis. Talk to you later.

Bye. Thanks for listening to today's episode. Be sure to head on over to drsusieg.com where you can get more information, show notes, and related articles on today's topic. Also, if you like what you're hearing, head on over to itunes subscribe to the podcast and leave us a rating and review we'd love to hear feedback thanks again

you're being modest that's what the british do