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What helps people move beyond pain and limitation, build resilience, and keep doing the things that give life meaning?
The Power of Doing What Matters is hosted by Dr. Clayton Skaggs, founder and CEO of the Central Institute for Human Performance and author of the book that inspired the show. For more than three decades, Dr. Skaggs and his team have worked at the intersection of persistent pain, rehabilitation, movement, and human performance. His career has included years of study with pioneering Czech neurologists Vladimir Janda and Karel Lewit, service on postdoctoral and research faculties at eight universities, published clinical research, and work with people ranging from those facing unresolved pain to elite athletes, military professionals, and executives.
Dr. Skaggs and his team have found that the best stories and learning come from the patients and clients. Each episode will combine stories from and about real-life experiences with clients, practitioners, athletes, researchers and others. Episodes combine practical knowledge, lived experience, and a CIHP Insight—a short reading that opens a larger conversation about the mind, body, and the choices that shape our capacity. Reading, contemplation and learning.
The conversations are educational and are not a substitute for personalized medical advice, diagnosis, or treatment.
Patience + Precision: Melissa Filla on Building Trust in Recovery
The Power of Doing What Matters
Host: Dr. Clayton Skaggs
Guest: Melissa Filla, ATC
Additional recorded voice: Mark
Final transcript
Melissa Filla: [00:00:00] When you have precision along with this patience, when you have clear objectives, things really come together and that leads to that self-efficacy that we're always hoping for with our patients and clients.
Clayton Skaggs: Hello, and welcome to another CIHP Audio Insight. And again, we are doing these audios to add contemplative and information, knowledge gathering for our clients and everyone else who's listening.
Today we have Melissa Filla with us and many of you who are clients or members for some time certainly know who Melissa is. She is our lead practitioner there at the Central Institute in St. Louis, has been for a long [00:01:00] time and just as many know, has great talent and experience of helping people on the floor and through their journey of pain and recovery, and also leads our team of practitioners there in St. Louis to get better and better all the time. So welcome, Melissa.
Melissa Filla: Happy to be here.
Clayton Skaggs: Wonderful. And this week we're continuing our talk on patience and patience is a wonderful word. It is, it's ironic that it is also symbolistic of the word patient and it is what's required to heal to be patient and to be patient as a patient.
[00:02:00] And I think you certainly of all of our teammates would know that. You've, you've been side by side with so many of our clients with persistent pain for years. Any initial thoughts on that idea of having patience for recovery?
Melissa Filla: Yeah. It's definitely something we all practice daily, individually, but our you know, our patients and clients, it's something that has to be learned.
And I think, you know, in recent discussions and your recent talk with Mark, we heard him comment about hammering away at his pain both through activity and golfing, et cetera. And really it was that learned patience that he had and developed with our approach that really let him really fly with recovery, less [00:03:00] pain, and then, recouping more quickly after he has had a pain episode.
Clayton Skaggs: Absolutely. Yeah. And we're gonna play one of, one of the clips from Mark, Mark's, conversation last week on the audio broadcast here in just a minute. And yeah, I thought he spoke to all those elements of patience that we've encountered. And, and I love, I loved some of his comments early on about how during the first three or maybe even said six months, he wasn't quite sure if the these simple exercises that we'd given him were working and yet he had the patience.
And I think what sometimes aligns with patience is trust. I just consulted a new client today and I made the comment to him. I said, "You know you're really gonna have to trust in what we're doing [00:04:00] because it's gonna seem simple." And so I think trust is a partner of patience
Melissa Filla: Yeah, for sure.
Clayton Skaggs: So you mentioned there in the beginning that we all practice it, and I think as practitioners, and maybe you can speak to this, as practitioners, we also have to have patience as our clients are learning and going down these paths. Patience for them to gain that trust and faith in what's happening for them.
Is there anything that, that, any story or anything you do that helps you have more patience?
Melissa Filla: Hmm. Yeah, great question. It's really about perspective. We have the really [00:05:00] the gift of being able to spend a lot of time with our clients. So it's easier to get to know them.
Spend some time thinking about being in their shoes. And really it's that interpersonal work we're doing where we can really tailor things to them. And that, that really helps give us perspective to have that patience. What are they thinking? What does this feel like to them?
Are they fearful? Are we recognizing that they're not trusting the process so that we can kind of step back, see things through their lens and and reminding ourselves to do that every day.
Clayton Skaggs: Yeah. That, that's great. I think as much, as much as we can to, to have their perspective where they are in their journey and learning is a key, a key piece for sure.
And [00:06:00] then, yeah, you're often spending three hours a week with a lot of these folks virtually and/or on site and, and that's a lot of time to get to know them and educate them on that, that perspective piece as well as patience piece. All right. Well, let's, let's go ahead and listen to Mark's little clip here on what he thought he was experiencing and doing all those years, all those twenty years with his gym work and golf work.
So I'm gonna go ahead and play this right now as just a follow-up, and then we'll comment on that at the end.
Mark: Yeah, I think of all the years that I had been working out in the gym, and I had been in pain [00:07:00] in many parts of my body for probably twenty-five to thirty years, and yet I continued to work through it. In my mind, I thought I still need to go to the gym and work out even though I'm feeling certain pain and you know, pain in different body parts.
It's still good to work out, and I should continue it. But just after hearing this story, that you just told about the bicycle, I was merely taking a hammer to my body every time I went to the gym. Like I was taking a hammer to my body every time I took a golf swing, and I was just creating more and more dysfunction. You know, a year ago or so, I had mentioned to you that I golf with a lot of guys in their mid-60s and they're not having [00:08:00] any problems, and you had said, "Not yet."
And it makes me think of so many of us start to have some dysfunction in our body in our 30s, 40s, 50s, and your comment of not yet was spot on because a year has gone by and several of my buddies have have got issues now. One is looking at a knee replacement, the other one's looking at a hip replacement, the other one's looking at having his neck fused.
None of these problems existed a year ago, and the question I always like to ask is did, did you have a severe injury to that part of your body? Seems like a basic common sense question, and the answer always is no.
So I see a lot of people in a dysfunctional state, especially in their mid-60s and even earlier, [00:09:00] and many times they do need a replacement. But, so often I think that time and patience and building up that resiliency can, I just look at what the clinic has done for me. I'm in an, a completely different place now.
Just feeling healthy, feeling more joyful, feeling strong, and, looking at life just, much differently these days, 'cause I'm feeling good.
Clayton Skaggs: All right. Yeah. Gosh I just want to, wanna pull him in for more and more talks because he just lands, lands so many good messages. So any, any thoughts on that?
Melissa Filla: Yeah I was thinking about this, [00:10:00] and we have this other wonderful client that actually you and I have both met with in the last week and he really reminds me of Mark in a lot of ways.
This gentleman has had pain for a long time, and he's very gritty. He has grit. So he's been working through his pain and dysfunction for years, decades. And his story doesn't completely parallel Mark's, but very similar. So, we really narrowed things in, hit the target, cut out most of everything he's doing, and this is a very active guy.
Instead of golf, this guy was paddleboarding, playing pickleball, hiking you name it, weightlifting. They're about the same age. And this other gentleman, he trusted us even though he really thrives on movement and [00:11:00] being outdoors. And we've really neuromuscularly limited his activity for the last three or so months.
You know, in the last few weeks, he's really reached out and asked to do a few more things. And what we did was we did a full reassessment on him, actually virtually, and it showed that he is consistently neuromuscularly showing that he's ready for more. And the discussion I had with this gentleman today is you're going to, you're going to hurt again similar to Mark's situation.
You're going to start grading into these activities, and you'll feel some things. You'll have some signaling, but you have the tools to get out of them more quickly and we're here and we'll help guide that. So, I'm really excited to see how this gentleman sort of progresses with his activity, clearance to do some more of his hobbies, and we're really hitting the ground running with some more weightlifting now.
[00:12:00] So, we see it every week, every day here at the clinic.
Clayton Skaggs: Yeah, I know who you're talking about and he too really was disciplined and did the work that we recommended and nothing else. Stopped all those activities that he really liked. And again, yeah, like Mark, he'll-- he now has the capacity.
We, we feel confident in saying, "Yep, go ahead, paddleboard. Go ahead and begin some more intense resistance work. And, and yes, you will likely bump into signals again. You will bump into some pain, and it'll be okay because you now have capacity that your body will respond and turn it around." Just like it turned around, turned it around with Mark versus leading to weeks and weeks of trouble.
And I think the, [00:13:00] the other part is when the, the pain is-- So I think both of these fellas, their, their pain really reduced, and then they were ready to start doing more, more things. And I think the... Sometimes the harder client is the one that is still having some signals, but we're seeing other objective measures improve.
They're gaining muscle, they're losing fat their movement tolerance through our testing is better. They're able to do a lunge now. They're able to do other movements that they couldn't do before, but they're still having their signals. They're still having their pain. And to help them know that, that things are better and to keep going even though they're still having some signals.
Those, those are sometimes a tougher spot for folks.
Melissa Filla: Yeah, they really are. And, and those folks, [00:14:00] it's, it's that graded exposure to the activity, developing new neuro tags to-- for their body to respond progressively better to familiar movements that at one time created signal. And that it's just, it's a slow build and there's no specific timeline on that.
It's individual for everybody. And I think these stories that we're telling and that our team tells with every interaction really can help folks start building that that trust even though they're still having the signaling. That their body can do it especially when we say green light to go to do this.
The stories are, are pretty important.
Clayton Skaggs: Yeah, for sure. Our brains, brains love stories. So appreciate you coming on, taking some time out of your day. Any last words on patience before we finish? [00:15:00]
Melissa Filla: Yeah. Something that really stuck out to me in this, in this series these interview with Mark and and the conversations afterwards was something actually that you said in a different part of the clip and that was precision.
When you have precision along with this patience, when you have clear objectives, things really come together and that leads to that self-efficacy that we're always hoping for with our patients and clients. So I just like that word.
Clayton Skaggs: Yeah. Thank you. Yeah, it, that came, came to me through a reading.
Precision is everything. And, it is, and it's what unleashes the amazing capacity of the body, that precision of hitting the target. It's what we, it's what we all are really trying to do. Well, cool. [00:16:00] Well, thanks. Thanks so much, and thank you to everyone who's listening in. If you haven't heard Mark's entire clip and YouTube audio, we're gonna link it at the bottom of this today so you can click on that and hear the whole thing.
The whole thing is worth the thirty minutes that, that it takes. He's got just a great story and a lot of great messages. So if you haven't heard that click onto that, and we will see you this Sunday with our upcoming insight. It'll be the second written series on patience: Stuck in Reverse.
Be sure to look for that this Sunday. And reach for the stars and help others reach for the stars. Thank [00:17:00] you.