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Transcript
- 11:42 Physical Therapy vs. Chiropractic
- 15:22 What is physical therapy?
- 19:38 Healing techniques used in physical therapy
- 24:19 Does physical therapy offer massage?
- 32:51 Osteopathic Technique
- 36:04 Electrostimulation
- 37:36 Pilates and other exercise techniques
- 43:23 What causes pain?
- 46:51 Problems with pain pills
- 50:37 When to see a physical therapist?
Wendy Myers: Good afternoon everyone. This is Wendy Myers. You were just listening to Everyday Animals, that song is called “Insane” from their new album, “Under the Tyranny of Good Weather.” It’s a fantastic album, go check it out. This is Live to 110 podcast. I’m a Health and Nutrition Coach. I started my site myersdetox.com™ to educate people about how to get healthy, how to lose weight, how to treat their health conditions naturally without medication, and how to detox from heavy metals and industrial chemicals that are so prevalent in today’s toxic world. And my goal at myersdetox.com™ is to basically help you avoid disease and live a long, long healthy life, living to 110. Please keep in mind that this program is not intended to diagnose or treat any disease or health condition because that would be illegal. Live to 110 radio is solely informational in nature. Please consult your health care practitioner before engaging in any treatment I suggest on the show.
And if you have any comments or questions for our guest today, Lider Chan, about physical therapy, please call in at 917-889-2838. Again that’s 917-889-2838. So pick up that phone and call in, don’t be shy. We want to hear all about your questions, if you’re in pain and we can maybe like check out your scenario and see what’s going on. So don’t be shy, call in.
Last week’s show was great. I interviewed Evan Brand from Notjustpaleo.com. We shed some light on basically how important it is to follow the footsteps of our ancestors by following a Paleo diet and talked a little bit about how to modify the Paleo diet, get it a little bit more healthy and relevant to today’s world. And also we gave you some caveman fitness tips with a few questions about ancestral health and fitness. So definitely check that out, if you’re wondering what all this fuss is about over the Paleo diet and this is the fantastic show.
Next week I’m interviewing Amahl Van Halsema of VHPilates.com. She’s a master Pilates instructor whom I’ve been working with for about 2 years and she’s a fantastic instructor and really incredibly knowledgeable, so I wanted to interview her and share her knowledge with you. She explores how Pilates improves your body and helps you rehab from injury. And I know how it tones your body and gives you an amazing body. During the show we’re going to explore the benefits of Pilates, the difference between reformer and mat classes, Pilates for pregnancy and post natal care, and also how Pilates helps with people that have multiple sclerosis, stenosis, and are weak from having injuries. We’re also going to talk about how Pilates benefits in men, and specifically how it compliments cross training in many sports like golf and equestrian sports etc. So check out this really fantastic show on Tuesday, April 30th at 2:00 PM.
Wendy Myers: So today’s show, I’m really excited. I’m going to be interviewing my brilliant physical therapist. How are you, Lider?
Lider Chan: Fine, hello everybody. It’s an honor to be on the show, Wendy. Thanks.
Wendy Myers: Thank you. I really want to have you on because I just think you have so much knowledge and you’re just so amazing in physical therapy. I worked with a lot of physical therapist and I just really haven’t had the accelerated improvement that I’ve had working with you.
Lider Chan: Thank you very much.
Wendy Myers: Yeah, you’re welcome. So I really wanted to have you on the show and let everyone know how they can also reduce their pain. Because you don’t have to walk around in pain and in agony. And so basically Lider, you work at Orthopedic and Physical Therapy & Associates in West Los Angeles and you’re a doctor of physical therapy. You have your doctorate from USC and basically I found you because I finally succumbed to physical therapy after I had unrelenting back pain following the birth of my child. And I put off getting help because basically I thought that physical therapy was for older, debilitated people. But I was basically in denial that I actually feel into this category.
Lider Chan: That’s actually what a lot of people thought to be honest with you. Yeah, it’s actually a common misunderstanding to this profession. We will actually talk a little bit more later on. I want to actually really introduce what physical therapy truly is to our listeners, that they may actually get an idea of when they need to see their physical therapist and what their physical therapist can do for them. We can actually talk about that later on as well.
Wendy Myers: Yeah because I hear about people in pain, I see some of my friends that are in a tremendous amount of pain and they just feel like they just have to deal with it and they just have to take pain pills to suppress their symptoms and listeners out there, you don’t have to live like that. You can get your body functioning how it was prior to your event or your injury. So that’s my message today: you don’t have to live in pain.
So Lider, you work at UCLA, you work at Orthopedic Physical Therapy Associates in West Los Angeles. And I hear that you did the USC doctorate program. How long did that take and how long was your experience there?
Lider Chan: Actually the time when I was in USC, they offered a different kind of program. I was a physical therapist in Taiwan back in the 90’s and after I came here they offered a different program for people who already got their degree in physical therapy, the Bachelor Degree in Physical Therapy to be continued to actually achieve a better or a higher educational level. So, I was in their post professional doctor of physical therapy program. It’s different than what they are offering right now, right now they actually try to shift the program into what they call Entry Level Doctor of Physical Therapy Program. So that means they don’t really take physical therapists who have already earned the degree before. Right now they want to actually promote physical therapy into the next level to have everybody actually graduate from a doctorate degree.
Wendy Myers: Good, good. And so, how did you go into physical therapy? Like what led you down that path?
Lider Chan: When I was back in Taiwan, I didn’t really know what physical therapy was at that time until I was in the school and I became a volunteer in the hospital. I started to see how physical therapists actually helped patients. And I started to get to know what physical therapy was and I found it fascinating. At that time when I got more encounter with patients, with therapists actually working with a patient at that time, so I wanted to be like them. But back in Taiwan in the late 90’s we didn’t really have a lot of advanced knowledge of what the physical therapist should do or what the physical therapist profession should go at that time, that’s why I decided to come to the United States to seek for higher degrees of education to try to figure it out. And after I graduated from here, I had that opportunity to start to practice here. I actually fell in love with this environment so that’s why I started my own practice over here and started to help patients over here.
Wendy Myers: Yeah. So then, California is a nice place to work? Haha.
Lider Chan: Yeah, it is.
Wendy Myers: And you know I have to say I’ve worked with a few of physical therapists before being referred to you by a really good friend and I was really bummed because she actually referred me to you about a year ago and I just put off going because I just kept thinking that my back pain was going to go away or somehow it was going to get better. And I did see some improvement with these other therapists, but I really improved by leaps and bounds since working with you. Because I’ve been working with you for about seven months or so, and for the first time in years, I’m not in pain all day long with back pain. So what do you think that you do differently from other physical therapists?
Lider Chan: Actually to become a therapist you need to really focus on examination or the evaluation part which is actually sometimes easily forgotten by a lot of therapists. You need to really know what your patient needs to be achieved in the beginning in order to make your treatment program and to make it effective. We all are being taught that in school but as we practice along with years, some of us kind of like forget about how important it is. I have to remind myself constantly as well because if you don’t have a good evaluation of what’s going on, on the patient, it will lead your treatment program to eventually be a failure halfway through, so you’re not going to be able to help your patient if you don’t start right.
Wendy Myers: What I noticed with you is, say this other therapists I worked with, they were spending an entire hour doing exercises and maybe occasionally they would do some electro stimulation where they put these little electrodes on your back and stimulate your muscles to relax them. But with you, you actually really get in there and just dig in to the body part and like you’re manipulating it and it’s actually a little bit painful, but I think that is definitely necessary to manipulate the body in a way to get it to change, to get to change the alignment or whatever and I didn’t have that with other physical therapist. We were just doing exercises. So why is that necessary to the physical manipulation?
Lider Chan: No problem. Let me elaborate on that a little bit. First of all, we need to actually differentiate us with a chiropractor. They use the word manipulation and use adjustment a lot. And I think a lot of the listeners actually are going to get easily confused with us and chiropractors as well.
First of all, we don’t really use that term a lot: adjustment. We like to use the term mobilization or joint mobility. That’s what we care about the most. As a physical therapist we evaluate the body’s adaptive dysfunction. That means that when the body is having some problem, they start to compensate and it starts to develop sort of a series of a dysfunctional adaptation based on the problem they’re having. So when that happens, sometimes muscle gains to a very tightness stage or eventually gains to spasm and the joints are not moving well. It depends on which joint. It could happen on your shoulder, on your spine, on your knee, on your hip, or even on the ankle, on the wrist. So we like to use techniques that actually help your joint to move and that’s very different than chiropractic assessment. So that’s a part that a lot of patients will actually be easily confused with. When we reach to the spine especially your neck or your mid-back, your lower back area, because they hear the popping sounds out or what we call crepitation.
Wendy Myers: I love that sound.
Lider Chan: Haha. We actually are not interested in that sound, we are interested in the mobility or how mobile the joint that we actually create and that’s what our treatment goal is. Because we need to identify what are the joints that are not functioning well, not moving well and we want to specifically treat those joints to make those joints to move better or to recover the movement of the joint.
Wendy Myers: Do chiropractors work with the joints? Because I was with a chiropractor, they only do my back. But do they work with joints, like ankle joints and knee joints and things like that?
Lider Chan: Yeah they do. Yeah we’re actually doing a lot more than just spine. We move almost every joint you can find in your body. We even move your jaw, the TMJ, the joint over there. We actually move every single joint you can find. So that’s a lot more than just spine, but I’m using spine as an example because it’s the easiest to hear. So a lot of my patients sometimes get excited hearing that, but I need to carefully explain to them that it’s not a chiropractic adjustment. So we don’t really get into a chiropractor’s category, because they do their adjustments for some reason. They want to do that in order to enhance the body’s function or some other knowledge-based techniques they are having over there. So, that’s the most important thing I need to have our listeners or my patients to know when I treat them in the beginning.
Wendy Myers: So, can you tell our listeners out there what exactly is physical therapy?
Lider Chan: Yeah. That’s actually a very big topic, but I can give a better idea in a very easy way. Physical therapy or physical therapist, they’re like teachers that help you to move well to retrieve your function or your healthy way to move your body. With physical therapy we don’t use medication; we use a variety of physical therapy agents or modalities to achieve the goal in the beginning. We use manual therapy, that means we use hands-on work to work on the patient like I said before, to help the joints to move, to calm down the tension on the muscle or to help the inflammation to go away from a certain area when you’re having it. And then physical therapist will actually make up exercise program specific, customized for a certain specific situation to help the patient to recover from their injured state to help them to go back to their healthy functional movement or situation.
Wendy Myers: Yeah I know. My goal is just to be able to go on a 30 minute walk without my back hurting. That’s just kind of pathetic, but it’s working.
Lider Chan: And you actually mentioned a very important thing. With physical therapy, we need to hear what the patient’s goal is, because sometimes if you don’t understand the patient’s goal, you might estimate too much or too little for the patient when you want them to reach a certain degree of treatment. Like for you, you want to have a 30 minute walk with a dog, we can actually achieve that based on what you want. But with athletes we need to set up a different goal if they want to go back to their sports or their professional performance. So it’s very different, that’s why I said that physical therapists, when they build up, when they establish the exercise program, it has to be very specific, it has to be customized. So it’s not like your gym exercise program that you exercise in the gym, it’s specific for your dysfunction or your injury. So that’s another part, a lot of what the patient doesn’t really see or don’t really understand. So whenever their physician asks them to see a physical therapist, they don’t really know what’s going on over there. So, this is actually a great opportunity for me to introduce what we’re doing to all the listeners.
Wendy Myers: Yeah. I had no idea why my OBGYN suggested that I see a physical therapist when my back pain post pregnancy was relenting, it wasn’t going away. I had no idea what it was and it took me a couple of months to make the call and finally signed up and started walking around with this pain, but I’m really glad that I finally made the call because I mean, that was 3 years ago. I worked with a couple of therapists before; I didn’t make the progress that I had hoped. But it takes some time for the body to change. But I want you to tell the listeners what kind of healing techniques are used? I know you do the manipulation but I want to hear more about electro stimulation and icing and maybe some other techniques you use to assist the people in healing.
Lider Chan: Sure. For physical therapy, we use a variety of techniques; the manual technique is one of them, is actually just one part of them. We use the electric stimulation to drop down the inflammation, help the muscle to relax or even promote the healing process. You can use it in different kinds of stage. We use ultrasonic treatment; now with diagnostic ultrasonic equipment, we use a therapeutic ultrasonic equipment to actually help to promote a deep layer of a muscle spasm or muscle pain to heal by relaxing them with ultrasonic treatment.
Wendy Myers: Yeah I love that one. I feel so much better after you use it on me. It’s like this deep, warm something that gets deep into the muscles.
Lider Chan: Yeah. Some of us, like me we use taping techniques. There’s a variety of taping that you can choose. I’m actually specializing in Kinesio taping. I found that really fascinating to either reduce the edema, especially pitting edema for my post operational patients after they just finish the surgery. And you can use Kinesio tape to reduce muscle spasm or tension or you can either promote a weak muscle area to make it function better. So that’s one of the specialties I’m using in my practice.
Wendy Myers: That’s interesting that taping can help edema and muscle weakness and spasming.
Lider Chan: Yeah and some of the therapists use laser to promote healing on a certain area. I don’t have laser in my practice, but I know that’s a pretty latest technology and I know there’s a growing amount of therapists using laser in their practice to help promote healing. And I think that’s pretty much the physical therapy modalities we’re using.
Wendy Myers: You use traction too, right?
Lider Chan: Yeah, we do use mechanical traction. But we use that for specific purpose, when the patient is actually having disc injury or disc situation, it depends upon the evaluation process. Traction can be very helpful to get rid of disc impingement to the nerve or the pressure to the nerve. It could actually help to regain pretty tremendous amount of function and reduce a lot of pain.
Wendy Myers: What is that exactly? Like what happens, is the person laid on the table?
Lider Chan: Yeah, we basically strap the patient on the table and we use the mechanical force to decompress the areas that are pinching on the nerve. So by doing that, we can shift the weight of the pressure from that area to help the patient to reduce the involvement of the specific pressure to the nerve. So that’s exactly how it does the work.
Wendy Myers: Like you’re pulling their neck, the machine that’s pulling the neck.
Lider Chan: Yeah, you pull the neck. You can pull the neck or you can pull the lower back, it depends upon the way you set it up. We set up either way, not both ways.
Wendy Myers: And you use icing too right?
Lider Chan: Yeah we do. It really depends upon the patient’s needs. We like to use icing in a very acute inflammation. And we use heat as well to reduce muscle’s tension or muscle stress. Those are part of a combined physical agent we use, usually on the patient along with electric stim.
Wendy Myers: A lot of people think they’re going to be coming in physical therapy to get a massage like they’re in a spa or something. Do you give massage in physical therapy?
Lider Chan: That’s another interesting comment. Yeah, I do have several patients coming in like they’re looking for a massage place. We do not massage, but we do therapeutic soft tissue work or soft tissue mobilization. The reason why we call it in that specific term is because when we move a certain muscle or a ligament or a soft tissue area, we’re actually doing it for a therapeutic purpose. We want to heal the muscles interference with that area. It’s really not going to be a very nice massage, like a nice relaxing massage that you’re going to expect in a spa. So a lot of patients end up having questions, “isn’t this supposed to be a nice relaxation massage?” No, it’s actually not.
Wendy Myers: I hear people like some funny noises, they’re screeching…
Lider Chan: So when you meet your physical therapist, you’re not going to expect the nice relaxation massage for the most part. They’re doing that for therapeutic purpose, sometimes they need to get rid of a lot of muscle tension you’re having or a lot of scar tissue formation you’re having. So they’re actually breaking down those problems. That’s involved with some pain because they’re stretching the pain fiber as well in that area.
Wendy Myers: Yeah, tell me about it. I’ve been coming to see you for about 6 months with all kinds of injuries namely both of my wrists were hurting from doing too much yoga, I’d sprain both of them and then even after they weren’t hurting anymore, you continued to adjust them. So why is this necessary exactly?
Lider Chan: First of all, we want the joints to be moving in a certain way that we like it to be. We don’t want any restriction with joint motion. But when you accumulate your injury or your dysfunctional condition for a certain time, I’ll say that about after 3 to 4 months, your body starts to adapt the changes. So it’s going to be hard to correct your body’s doing. Especially when you’re carrying that chronic situation, we have to educate your body to move in the right way, but sometimes we can achieve it with only one visit, with only one treatment. So sometimes it’s necessary for us to correct the way that your body moves.
Wendy Myers: It’s as if your body kind of wants to go to the old holding pattern, the old the alignment
Lider Chan: Yeah. So once we achieve that, usually we’ll follow with exercise to try to get you out of the cycle because we don’t want to have you sustain that cycle forever. So that’s actually a very important part of physical therapy. We want to educate our patients to get rid of the cycle especially the pain cycle there getting involved with. That way they don’t have to see us forever.
Wendy Myers: Okay. So it’s also important to not think you’ll be able to go in there and get a quick fix with a physical therapist. It takes time for the body to change, it takes time for the body to realign and it takes time to teach the body to stay in that proper alignment. So you’re looking at some time to heal your body, it’s not going to happen overnight.
Lider Chan: No, it does not. And like I said earlier before, through our research we find that after your body is in pain or in dysfunction for about 3 to 4 months, it actually starts to imprint those memories into your movement pattern. So that’s why it becomes chronic because our bodies just learn from that information. So when we get patients out of those cycles, it does take time because we want the body to receive new information to correct their movement pattern to help them to move in a healthier way again.
Wendy Myers: Yeah. So it would probably take 3 or 4 months for the brain to learn the new pattern.
Lider Chan: It really depends how long you’ve been suffering. The longer you’re suffering, that imprint message gets more stubborn. So I’ll say that if you’re actually acquiring a new injury, it will be a lot faster to take care of it if it’s within about 3 months. After it passed about 3 or 4 months mark, we’re going to either spend about twice as long to really get your body to go or sometimes even longer than that. If it’s more than about a year or two. I do have patients come in to the office when they’re suffering with the pain or the same pain pattern for about 2 or 3 years. And those are the patients that are actually very difficult to pull out of their pain cycle. So it does involve a lot of work, a lot of time. Those are the patients I always tell them that you probably are going to expect that you’re going to stay with us for a longer time, like about 4 or 5 months to actually break out that pattern.
Wendy Myers: Yeah. So that reiterates the point that listeners out there, if you’re in pain, don’t wait to get help. Don’t go to your doctor and just accept he’s just going to give you pain medication, because that’s only going to make it worst. But get in to see someone – a physical therapist, preferably Lider, if you live in Los Angeles.
Lider Chan: Thank you Wendy.
Wendy Myers: The longer you wait the worst it’s just going to get and the longer it’s going to take to heal. So I have another question, whenever I come to the office you adjust my back every time. Why exactly is that necessary to adjust my spine?
Lider Chan: Once again, it’s really involved with how long you’ve been suffering with that lower back pain and what kind of injury you got originally in the beginning. Like for Wendy’s situation, because a lot of her joints are now actually moving exactly the way that we wanted to be. Even though we gave her numerous treatments already, so that’s why we need to continue to give them the right information. But like I said, after we give that right information, we want to move the body the way we want. So we usually will accompany with exercise to help the body to change. So for Wendy’s case, it’s actually being a long time so it’s really hard to have the body to really get the right information for just a few times. That’s why we have to continue to give her the treatment in order to help the body to pick the right information. That’s why, Wendy. That’s why we need to continue to give you that treatment.
Wendy Myers: I think my spine does want to keep popping out of alignment. I mean I come in once a week and that’s every week the whole spine adjust, cracks so to speak. I know you probably hate that work. Like you just have to force it back in the line, back into the proper alignment.
Lider Chan: Alignment is actually the terminology that chiropractors use a lot in their profession. So we don’t really use that word. Like I said in the beginning, we use the word mobility. Your individual joints’ mobility is just really not good. So we have to continue to provide the mobility for you to use those joints, otherwise you’re not going to use it. That’s it.
Wendy Myers: And so, what is that technique you use? I was talking to someone, they said that you kind of use an osteopathic technique.
Lider Chan: Yeah. I was fortunate enough. I have a continued education with the USC and they have the doctor of Osteopath start to teach us how to mobilize our patients more correctly. So I was fortunate enough, I could actually retrieve that training and I’ve been using that a lot. Often times when we mobilize our patients correctly their body will respond to a better way and heal in a better way. So I’m actually using a lot of that right now.
Wendy Myers: So what is the difference between the osteopathic technique that you use and the chiropractic technique?
Lider Chan: Like I said, we need to find a specific joint, that’s what we do a lot. We don’t use very high velocity force. We use more like a gentle force and we like to get the muscle to get involved. So that’s hugely different. Even if sometimes you still hear some crepitation or some popping sounds, or cracking.
Wendy Myers: I love that sound.
Lider Chan: Like I said, we don’t really look for that. We look for the joint to move in a normal physiological way.
Wendy Myers: Yeah. I noticed definitely after you manipulated my back and put it back into the proper mobility, my back is definitely sore the next day. Like the muscles are in a new pattern, they’re kind of sore.
Lider Chan: Imagine that if we tied up your elbow or your shoulder for quite a long time and we tried to release it, you would feel the same amount of soreness. That’s actually such a tiny, for example in your case, it’s actually a very tiny joint. That’s why you don’t really feel it in your normal life, but it’s exactly what you’re doing, to tie up your joints over there. So when we first release those joints from immobility, it must be soreness coming out of that area, because you just resumed the joint circulation and the joint started to move. So yeah. That’s how much it takes.
Wendy Myers: Okay. So, I want to revisit the electro-stim that you use. I want you to explain exactly what that is and exactly why you use it. Because I know what it is, is you take about 4 metal pads that transmit the electricity.
Lider Chan: Four electrodes.
Wendy Myers: And you hook up the wires to this machine and I sit there for 15 minutes while it’s kind of contracting and relaxing, contracting and relaxing and after 15 minutes that feels like you’ve had an hour massage, like your muscles are totally relaxed. I love it. So what purpose does that serve and why you use it?
Lider Chan: We use it for different reasons. In a very acute stage of injury like when there’s a lot of inflammation, we usually use that with ice together. We’re hoping to actually use that pumping or whatever you’re feeling you just described, along with ice to really calm down the inflammation in the area. And especially in really acute, swollen or inflamed area. And also the numbing effect from the the electro stim or electrostimulation itself will actually help to reduce the pain feeling when patients first come in, when they’re really inflamed. So that’s a really good tool to use, but in the later on stage like your stage when there’s a chronic muscle tension or a really higher tension, we use that with heat to promote the circulation and to reduce the tension on the muscle and at the meantime give you a nice massage feeling. So it depends on each stage; we can use it with a different purpose, that’s what I’m trying to say.
Wendy Myers: Okay. And I know that you have some Pilates equipment in the office.
Lider Chan: Yes, I do.
Wendy Myers: How are Pilates and other exercise techniques use to help patients?
Lider Chan: Pilates equipment we’re having in our office is just one of the many exercise techniques we use to help patients. Not like Van, who’s the guest you’re going to invite next week, I’m not a Pilates instructor. So what we’re doing is just retrieving some of the Pilates technique or some Pilates exercise that are actually suitable for specific needs of the patient. We’re not going the entire Pilates program in my practice. And we also utilize some other very different exercise techniques to help patients. One of our unique techniques when we’re evaluating a patient’s need in terms of therapeutic exercise program, is we actually specifically target their long lost function.
For example, if an athlete comes in, if there’s a pitcher from the baseball team, when he comes in we have a shoulder issue. We don’t really only focus on the shoulder because sometimes it’s not the shoulder that’s the area that needs to be blamed for or need to be taking the credit of the dysfunction. We search it down to the entire body to find where are the associated dysfunction along with the shoulder pain. So sometimes you’re going to amazed to find out a pitcher is actually having ankle sprain or ankle injury in the beginning and he starts to adjust his pitching posture and start to actually irritate his rotator cuff to start some inflammation on the rotator cuff tendon and end up with some more further injury. However, if you have that pitcher just work out in the gym to regain shoulder strength, it’s really not enough. You need to carefully exam that particular situation and try to find where’s the other source that’s actually causing that particular problem.
So in this case, this is an actual patient we’re having. He’s acquired ankle sprain repetitively from other sports. He likes to play soccer as well and he ended up adjusting his own posture while he’s pitching and ended up giving himself a rotator cuff injury. So one beauty of our exercise program is see that and we can customize it for a patient with a different need. And we like to train patients in a very different way than you guys are being trained in the gym. Because in the gym you’re more focused on the definition of a muscle, you want to look good with the muscle’s definition or you want the muscle to show up, or to stand out. In our exercise program, we don’t really do that, we train the muscle to be functioning in the right way with the right strength, so a lot of our exercises; we will not specifically train one muscle only. We’re actually training different muscles, even different body groups or different joints in a systematic way or in an integrated way to have them to function maximizing either athlete’s performance or maximizing strength when you need it to recover yourself to a normal physiological movement pattern. I hope that I answered your question a little bit better.
Wendy Myers: Yeah. I have to say I know what the athlete feel with just kind of transference of one injury to another. Because I kind of have a similar feeling when I’m sitting on my butt writing my blog, my butt hurts. And I’ve gotten into you and I was like, “Lider my butt is hurting with the very end of my tail bone.” And it really was a muscle, kind of like my lower back that was tight or irritated causing the transference of pain to the bottom of my butt.
Lider Chan: Exactly.
Wendy Myers: It’s funny because you think that the pain is being caused exactly from the area from where it’s coming, but it’s actually going to be from another area.
Lider Chan: Yeah, exactly. I was using a very extreme case because that was a really funny case we found. But my point is, sometimes where you have pain is not necessarily where it’s actually causing the pain. So that part is the value of a physical therapist because we will be able to try to identify or at least to find the link between those for you to understand your body a little bit better. That way you don’t acquire the same kind of injury again. So it’s the most valuable, I mean stand out position we’re having.
Wendy Myers: Well you know, here’s a basic question for you. What exactly causes pain?
Lider Chan: Okay. That’s a very broad question. So it really depends about what kind of pain you’re having. First of all, pain is a learning behavior we don’t really acquire that when we were first born. Some of the pain is a learning behavior. So again it’s a really broad topic so I’ll try to be brief and short. Pain usually is a signal that warns your body that something is wrong, but it can’t explain itself. So when you have pain, you probably need to respect that even though it’s starting with some minor stuff. So when you pay more respect to the pain signal, you’re actually being able to regain your health a lot faster. Different kinds of pain will lead you to different kinds of professions to try to get help. But for a lot of us there’s a pain signal that we try not to deal with and it’s pretty often that we do that. It’s like the nagging achy pain specifically speaking, it could be from the lower back, it could be from the neck, it could be from any kind of joints that you use a lot; like your shoulder or your elbow.
Sometimes when you acquire a nagging achy pain, you just pop in the pain pills or some anti inflammatory to actually try to control it. But when you accumulate enough change or enough pathological change, it actually becomes a true damage to the structure. So what I’m trying to say is when that happens, it’s actually harder to treat it. So a very simple rule to respect your pain is when you actually have a pain repeatedly and you cannot control that with your pain pill, it comes on again and again it’s actually the time that you seek for professional help. Either you can go to your physician or you can go to your physical therapist, depends upon what kind of pain you’re having. If it’s related to any dysfunctional injury like posture, you’re not having a good posture and you know for sure that the pain should come for that, or you require some dysfunctional movement pattern that the pain is coming from that. You can try to seek help from your physical therapist. And I think that’s healthier attitude to face the pain.
Wendy Myers: A few clients I referred to you have waited years to seek treatment and just pooped pain pills to get through the day. What are some of the problems with taking pain pills for pain and how exactly does this worsen someone’s condition?
Lider Chan: Yeah. As we always educate our patients or as a lot of the physicians educating their patients, that’s another big topic of pain. When you pop in a lot of pain pills, you raise your threshold to detect the pain and it becomes a cycle. It becomes a pain cycle. So it’s not only masking the symptoms of the original injury you’re having. It’s also making your body truly more adaptive to changes. So that means your body is actually going to be more dysfunctional or the injury that you’re suffering is going to become worst, but you’re just actually using those pills to mask the true situation that you’re having. And later on it becomes a learning cycle. So you’re educating your body to be okay in that kind of way and it will really deteriorate your body’s health and not only that, eventually your mental health as well because you’re going to be dependent upon to have your dosage of a pain pill or a stronger kind of pill. It’s really not a good cycle, we don’t want our patients or our listeners to stay with.
Wendy Myers: Yeah, I got stuck in a cycle like that. Before I got pregnant, I don’t know why I kind of hurt my lower back and I started taking Vicodin for it because hey, I was in pain. I needed to take a pain pill and I slowly learned that because I couldn’t feel my back, I would do things that I shouldn’t be doing because it would hurt normally which is basically the signal that my body is giving me to tell me to stop and stop doing this activity and lie down. But I was also injuring my back more and more because I couldn’t feel the pain that is signaled to my body to like, “Shut up and sit down.” And so I was doing that and I stayed on this pain pills for quite a while before it finally dawned on me, if I don’t stop taking them, my back is never going to heal.
Lider Chan: So yeah that’s actually the cycle that we’ve been talking about. Your body is not moving towards to healing. It’s actually moving to a pathological adaptation. So you’re just dragging yourself away from healing more and more. And now with that you’re giving your physician or your therapist a big headache if you continue to do that, because there will be very few things they can do for you, other than keep increasing your pain medication or give you a stronger kind of a pain medication until you feel it and it’s really not a good pathway to stay on.
Wendy Myers: When I was first injured, I injured my back about 6 weeks after I had my baby, I started working out thinking I could just work out like I used to even though I hadn’t worked out for 9 months. I did not want to see a physical therapist because I thought it was for elderly people who are out of shape and that wasn’t me. So I postponed treatment for months until I just couldn’t take my back pain any more. What can happen if you wait too long when you’re in pain to see a physical therapist or other healing practitioner?
Lider Chan: Like I said it could actually go into that kind of pain cycle we’re just talking about and to correct that, I think a lot of the patients when they’re hesitating to see a therapist, that’s one of their many thoughts. They just think that therapists are for elderly patients to go to, to work with or to teach them how to exercise or to walk. But to answer your question a little bit better, physical therapists see a variety kind of patients. Our patient age group are starting from infant all the way to about 90-95 years old. I actually have a 93 year old in our practice and I have as little as a 4 year old in my practice as well.
If you really wait for too long, unavoidably you’re going to set yourself into that kind of a pain cycle, it’s an endless cycle. You’ll never going to get a chance to come over that cycle and you’re dependent upon your pain medication forever which is really not a good thing to do.
Wendy Myers: Yeah and a lot of people do that. They just wait a long time. For instance, I referred a few patients to come to your office that they’re just in so much pain that you couldn’t even touch them. So what may someone have to do before you’re able to treat them if they’re in so much pain that you’re not able to give them more mobility or manipulate their back?
Lider Chan: This is a part that we need to coordinate well with pain management physicians. If the patient’s inflammation or pain is really outrageous and we can’t really control or contain it up from our treatment, oftentimes we need to get help from the pain management physician. They could help patient to do more stuff in terms of their injections or their other kind of approach to shut that cycle down in a more aggressive way. And in that time I will either refer the patient to a proper physician or to consult with their referring physicians to see if we can get together to offer more aggressive help, not just from the physical therapy point of view but to get some other professional’s opinion and idea to help the patient in a better way.
Wendy Myers: So these injections that you talked about, those are for, I’m assuming to reduce inflammation?
Lider Chan: Reduce inflammation; reduce the pain to get rid of the pain cycle that we’re just talking about like popping the pain pills and whether to subside it and the pain starts again. Often times, pain management physicians, they could do an aggressive approach to really put that cycle down for the patient to start physical therapy. That way patients actually get greater results and they don’t have to wait for a long time for those situations to shut down.
Wendy Myers: Okay. So how long after an injury should you see a physical therapist? There’s some people think they should wait like it should heal for a few days first before they see one.
Lider Chan: Depends upon every individual situation, but you can see a therapist as soon as you think you get the injury. So we often times would give you a better idea of what kind of injury you might have and what the healing time is and how long you need to see us. So I’ll say that you can actually do that as soon as possible.
Wendy Myers: So right after the injury.
Lider Chan: Yeah right after the injury.
Wendy Myers: Okay. So I understand all the top neurosurgeons in Los Angeles refer their patients to you. How exactly do you help patients with neurological problems?
Lider Chan: Yeah. We see a lot of thoracic outlet syndrome patients abbreviation TOS. They’re actually a very unique group. That’s one of the neurological problems we’re seeing in our practice. So again, I think the most valuable thing we do in our practice is we identify where the dysfunction is. We’re not trying to identify the pathological changes, we’re identifying the dysfunction. With that kind of approach it’s more effective for those kind of patients to take. So especially with thoracic outlet syndrome, those patients’ group because they’re oftentimes in chronic pain and not only that, it’s very broad area. It has different kind of situations ongoing. So a proper evaluation and examination to determine what a patient truly need is very important to start the patient’s care and that’s what we do the best.
Wendy Myers: I guess what I’m getting at is I think like you’re so good at what you do. That I have a friend of mine that comes and see you and not only can you manipulate people physically, do work with their muscle and whatnot, but you could also help with neurological conditions, like work with the nerves. Like my friend, she has a problem, her health condition kind of irritates her ocular nerve and she says that you are able to calm that own and stop that nerve from irritating her eye. And I think that’s where your genius lays, is you are so knowledgeable about the body; not only the muscles but the nerves and everything that you’re able to take care of a lot of health conditions and neurological conditions that a lot of other physical therapists aren’t able to touch or even know about.
Lider Chan: Yeah, those are our specialties but again we need to carefully consult with their physician to understand what the nature of the problem is and then we can actually start to take care of the patient. It depends upon what kind of situation they’re in. It’s hard to explain really into details right now but we do offer that kind of specific treatment for the nerve situation or nerve problem.
Wendy Myers: Okay. Yeah I guess it’s kind of hard to explain how you work on nerves.
Lider Chan: No, it’s just we have a pretty limited time. That should be a specific topic that we need to go into in terms of how we actually help patients to get rid of that kind of problem. So that way we can get more specific into those conditions. Because neurological problems are too broad kind of a topic.
Wendy Myers: Yeah that’s a whole another show.
Lider Chan: Yeah. It can be broken down into a variety of situations. Some situations, they’re really going to be beneficial from physical therapy, but some other conditions when we identify that, we need other professionals to get in to help. So that’s why I can’t really answer that question in a perfect way.
Wendy Myers: Okay. Well Lider, I guess that we’re out of time and I thank you so much.
Lider Chan: No problem.
Wendy Myers: I really wanted to express to people how gifted you are that you have so many talents and that you are able to help such a wide variety of health conditions and help people improve them and work in conjunction with their doctors to improve their not only physical problems but neurological problems as well. So I thank you so much for being on the show. And definitely to listeners out there, if you live in Los Angeles area, if you’re in pain, definitely give Lider a call. Lider what’s your phone number where people can contact you?
Lider Chan: Sure. My phone number is 310-209-2011 extension 2. That’s my office number.
Wendy Myers: Great. Thank you so much for being on the show, Lider. I’ll see you next Wednesday.
Lider Chan: Thank you, Wendy for inviting me to the show. Yeah. You have a nice day.
Wendy Myers: Yeah. Thank you so much. Okay. Bye-bye.
So listener’s out there don’t forget next week I’ll be interviewing Van Halsema from VHPilates.com. Call in and ask a Pilates master how Pilates can help you. So talk to you soon and thank you for listening. This is Wendy Myers signing off.
