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Hey Padel enthusiasts welcome to Padel Smash Academy, I am Cesc and I am here with Julian and we're all about Padel! Whether you're new to the sport or an experienced player, you've come to the right place. Our goal is to provide you with the best tips & tricks, news, and weekly lessons to help you improve your game and take your Padel to the next level. So grab your Padel Racket and let's get started with all things Padel on Padel Smash Academy.
Today we have the Mesmer Horizon.
Incredible.
Pamela Palominos.
He's a world famous, uh, physical
therapist and a, and, and chiropractor.
Welcome to Paddle Smash Academy.
Oh, and we are all things paddle.
So I am, like my degree says
chiropractor, but the school that I
went to, um, was really rehabilitation
focused and did a lot of other things
aside just from the adjustments.
There's some chiro schools you can
go to that are, they only focus on
adjusting, which is like the cracking
that you would traditionally get with
a chiropractor, um, which is great.
But my school was like, that's an
awesome tool to have and you are
obviously gonna learn it, but we're
gonna show you so many other things
like exercise, rehabilitation, soft
tissue work, cupping, all these
other types of soft tissue therapy.
Um, Where some schools
don't always do that.
So I am, my degree is
a chiropractic degree.
Um, our school also made us
take physical therapy boards.
So definitely a little bit of both,
but my degree says DC What, what,
what is a big difference in between
physical therapists and chiropractic?
And why do, do they hate each other?
Because my wife is a physical
therapist and she goes, oh my God, the
chiropractors are ho, you know, horrible.
Yeah.
So what is a big difference?
So that is actually
changing a lot right now.
Uh, my thought, or most people's thought
these days, if you're in the chiropractic
or physical therapy world, should be if
you're going to a good chiro or you're
going to a good physical therapist, it
should be hard to tell the difference
whether they're a chiropractor or
whether they're a physical therapist.
That's how you know you're
going to someone who is.
I guess up to date on all the
information about what's going on.
I have patients that I see sometimes,
and I don't adjust 'em at all.
It just depends on what
they've got going on.
Right.
Um, physical therapists and
chiropractors traditionally don't
like each other because A, you're
competing essentially for clientele.
Uh, historically chiropractors
have only adjusted people.
Like they've only done the
cracking like I spoke about.
And then physical therapists
only did exercise.
They didn't do anything else.
They just did exercises with patients.
O okay.
And can you fix people
only by just cracking them?
Some people say yes, and like I said
before, it is a very helpful tool.
When we were in school, they told us about
patients that you're gonna have, and they
call them like the Chiropractic Miracle
patients, where you literally adjust them
once they've had this like pain, let's say
for years, and you adjust them one time.
And for some reason that one
adjustment was just what they needed
and the pain magically goes away.
I'm gonna tell you right now,
I've been practicing now four,
four years and I haven't had a
chiropractic miracle patient yet.
Okay.
Where with one adjustment it gets better.
I wish that happened to me.
I know.
One adjustment.
No, that would be great.
All right, so I gotta
talk to you about Paddle.
Yes.
How did you become, uh, the physical
therapist for, for paddles and
was it the Miami Paddle Open?
How did that start there
and how did you start?
Uh, you know, um, working at, uh,
Wynwood Paddle Club, basically I was
working in Aventura with my current boss.
Um, he started to play
paddle and Interesting.
Yes.
Became, um, Like, loved it.
I mean, everyone, everyone who
starts to play addicted, addicted,
um, from what I understand, his,
his friend's also very addicted.
Um, and my husband actually
started treating one of the
owners of Windwood Paddle.
And I think basically what happened
was, like my, um, they were interested
in having someone, some sort of
physical therapy chiropractic person
in the club and the owner was like,
oh my gosh, like this is going great.
You guys would be awesome, an awesome fit.
And then my boss and
him connected and Great.
That's awesome.
So how, so what do you see
in, well, how did you get the,
uh, the Miami paddle open?
Like the, you're the
physical therapist for them.
Like how did that happen?
I think this would be experience.
It was, well, it was nuts because
I had just started working there.
I had been there I think a month.
So it was a little bit nerve-wracking
going in there and like, you're
treating all these people that, like,
people are, they're famous, right.
You know?
Right.
Um, So basically I think it was just,
oh, we're working at the club, but
the club was like, oh, why doesn't
your company be the ones treating?
And since I was at the club, my boss
was like, you should be the lead.
You know, you know the
people working here.
Um, but it was nuts.
It was like treating most athletes though.
Yeah.
Yeah.
The thing about athletes in the
regular population is athletes,
you were like digging into them
and they don't even notice.
They're like on their phone.
Wow.
They're texting normal.
Not me.
Regular world people are like,
oh my god, that's too much.
I'm crying.
Yeah, yeah, yeah.
I hear you.
So, so famous person did you,
uh, work on They're the mine pal.
Oh.
I never know if I'm allowed
to say names or not.
I just can Of course, definitely.
Okay.
You know, um, uh, LeBron was one of them.
Yeah.
LeBron.
Yeah.
I don't know.
Yes.
Yeah.
Lovo LeBron.
Yeah.
Yeah.
LeBron Paddle play.
No.
LeBron James.
Correct.
Not LeBron James.
Not LeBron James.
I don't think specific but
LeBron, that's all say to me.
Yeah.
What was it from when,
when he came to you?
So, at the Paddle, uh, the
World Paddle Tour, it was mainly
people coming in like post-game.
Some people came on pre, pre-game to
like get warmed up and ready to go.
Most people came in post-game.
It was really hot that weekend.
I'm not sure if you guys remember.
Yeah, yeah.
It was, I think they ha they
were shocked by the heat and
being like right on the water.
So most people came in
with like leg cramps.
Wow.
Leg tiredness, glute pain.
Wow.
Lower body was what I, I was assuming.
Shoulders, arms, yeah.
Elbows.
I, I, I wanna say lower body
was like 80% of what I treated
Sounds like me all the time.
Every time I play 80% of what I treated
there was definitely lower body.
For sure.
Wow.
Interesting.
Mm-hmm.
And lemme miss one thing, one
of the major issues that we get,
uh, me as a paddle coach as well.
It's, it's tennis elbow or paddle elbow.
Elbow.
Yes.
Yes.
Let me know what will be,
do you know what causes it?
Well, how to prevent it.
How to cure it.
Well, what's the most
injuries you see there?
Probably that, uh, the
tennis elbow, right?
Paddle tennis elbow for sure is up there.
Oh, okay.
So that's, which is what, what is it?
The, the medical term?
Uh, lateral epicondylitis.
Okay.
Yeah.
So called tennis elbow.
Tennis elbow.
Tennis elbow.
There's also, believe it or not,
I've gotten a few, uh, golfers
elbow also from paddle players.
The me that just means like
the, the middle most people.
It hurts here, right?
On the outside.
Yes.
Yeah.
Um, I've gotten a few people come
in with medial elbow pain too.
Okay.
Uh, which is golfer's elbow.
Um, but you can, you can
get it too in, in paddle.
Yes.
You can get it in the
inside or, or the outside.
I would say most is the outside.
Yeah.
I've had a few rare cases that it, it's
from, they told me they only play paddle.
And it's the medial elbow.
Okay.
Yeah.
So, so what's the treatment for that?
What, what, what's the exercise
when they come in to see you?
Mm-hmm.
Uh, what do you do to, to them
To relieve them from that?
From that pain?
Yeah.
And what can they do at home?
Well, what, but define first
before we go into that.
It's what, what is happening?
Your body.
Exactly.
Yeah.
So lateral epicondylitis or tennis slash
paddle elbow is an, an overuse injury.
So it be basically is an overuse of
your extensor muscles in your forearm.
So anytime you do this motion where
you bring your wrist back mm-hmm.
You're using extension.
So it's just an overuse injury.
You're using those muscles over
and over and over and over again.
And when that happens, that
muscle will get nice and tight.
Most people won't notice
tight el tight forearms.
The, when they start to notice
it is, when it gets so tight that
it starts to pull on the tendon.
When that happens.
Oh, okay.
It will cause inflammation.
You get tendon pulling, you're
gonna get inflammation in that area.
And that's when people are
like, Ooh, I think I have
tendon elbow or golfer's elbow.
It usually gets to a point.
Where they're already not so far gone,
but the, the tightness in the forearm
is already so advanced that now it's
turned into tennis elbow or Wow.
And, and paddle elbow.
And, and, uh, let me ask you one very
important thing, you know, always,
because me, I'm in the other side, when
they come with the tennis elbow and all
that, or let's call it paddle elbow.
Mm-hmm.
It's, there are different cases
where the one is so s severe that
they could not even pick them.
The, the coffee cup and
it, it really hurts.
Mm-hmm.
You know, and the other
ones, they're not there yet.
So when, so when they're
at that level, yeah.
What will be the proper treatment when
they're at, at the point where like they
can't hold a coffee cup or they can't
text or they can't, like, twist things
off jars or shaking someone's hand hurts.
Right.
When it's so bad like that you can
do traditional physical therapy,
chiropractic treatment, it will
take much longer, like much longer.
Nowadays what they have are PRP
injections, stem, what's PRP injections?
Platelet-rich plasma injections.
So essentially, I am not an expert
in this, but what they do is they dry
your blood, they spin it, they get not
the red blood cells, some oth other
nutrients in your blood and they inject
it into the area that is injured.
I've done that twice.
I was gonna say, I know Caesar's done it.
It's the most pain I've ever felt in
my life when they put that in my bed.
Really?
Yeah.
It's unbearable.
But you know what?
It it advanced the healing.
I mean, I was mean, it's two weeks
now and I ripped, uh, uh, 50% of
my, uh, my, what do you call it?
My at attendant down there.
Yeah.
And, and now, uh, I'm able to
walk and maybe just move around.
I thought I was gonna be on
crutches for like months.
Oh, that's what I mean.
So like when you have tennis elbow or
paddle elbow that is that advanced,
like to the point where it's, it's
hard to even like shake someone's
hand and you can't hold anything.
If you are wanting to get back to
paddle as soon as possible, you're
looking at, it's better to do something.
Regenerative medicine.
So platelet rich plasma injection.
Stem cell injection.
They have a bunch of other things,
exosomes, all these things that they can
put into your joint and their muscle.
Can you do that?
So you can do it at our company?
Yep.
Okay.
So we have a doctor on staff, Dr.
Povera.
He's awesome.
And he is a regenerative
medicine specialist.
He works with essentially all extremity
joints, so shoulders, wrists, knees, hips,
ankles, um, yes, all the extremity joints.
He does, uh, spinal injections for
those types of things are not as well
researched and not, um, there's not
as much evidence behind it quite yet.
They need to do more studies, but lots
of evidence behind elbow injections,
knee injections, ankle injections.
And that really works.
I mean, have you seen improvements
quick as Yes, I've had lots of patients.
Lots.
If Cesar had not gone, yeah,
he would've been probably on
crutches, like he said, for months.
Yes.
Yeah, months.
So it makes a world of a difference.
So now when it's not that far gone,
um, What is the, what do you, what do
you do to relieve that, that problem
that they have in tennis level?
So I had a few patients
actually today that I treated.
Um, I did dry needling is okay.
What I personally have
found that works the best.
Dry needling And what is that?
Yeah, yeah.
It's a form of acupuncture.
Okay.
Um, it is different than
Chinese medicine, acupuncture.
What you're doing is you're just
dealing with the musculoskeletal system.
Um, so essentially if you came
in with tennis elbow, I'm just
putting needles into your forearm.
And other areas that
would affect the elbow.
Right.
When you go to a traditional Chinese
medicine acupuncturist, they, they might
put some in your elbow, but they might
put some all over the body depending
on the meridians that affect the elbow.
Interesting.
Yeah.
Yeah.
But you did that to me.
I've done it to you.
But, but they put it all along
your, your arm, your form.
Yeah.
Wow.
And sometimes depending on the
patient and, um, how much pain
they can tolerate or if they've
ever done dry needling before, I
sometimes attach electricity too.
So it causes the muscle to stimulate.
Oh yeah.
That's when you get that,
that the contract relax.
Contract relax.
So explain, explain to
people how that that works.
Yeah.
And how that helps.
So the needle itself is super, super
helpful because what you're trying to do
is a calm down the nervous system when
your muscles are really tight in one area,
like hap what happens with paddle elbow?
Um, the nervous system there is
irritated and super fired up.
So the needles will help
calm it down when you pierce.
Uh, a muscle with a needle, you're gonna
relax that muscle, but you're also gonna
relax the nerve that supplies that muscle.
Right.
Gotcha.
So an, uh, when you attach the
electricity to it, it also helps
because you are going to contract
the muscle quickly and then relax it.
The quick contraction is what
helps the muscle relax really well.
It's also gonna help
push out inflammation.
When you have an overuse injury like
that, where it starts affecting the
tendons in the elbow, you have generally
a lot of inflammation in that area and
you wanna pump that inflammation out.
Inflammation is good if it is moving.
If it's just sitting and
pooling there, it's not good.
So that's why putting the needles
in, having the contraction and the
relax relaxation is super helpful.
Okay.
And so how can people at home,
uh, uh, you know, treat themselves
if they have a tennis, is there
anything that they can do?
For sure.
Uh, icing is always gonna be
helpful, especially if you've
had a long day of playing.
I know Cesar sometimes
gets pulled into matches.
Yes.
Yes.
A lot of matches.
No, we, we, we shouldn't call it
all day, but maybe two hours all day
of playing is more like two hours.
Okay.
Better than half an hour.
Yeah.
So, uh, icing at the end of a, a long day
of playing is always gonna be helpful.
Um, stretching.
Okay.
This is a weird muscle to stretch
because everyone thinks that this
is the way you should stretch it.
Now, don't get me wrong, that'll be
helpful, but we're trying to stretch
the muscles on the top here, right?
So best thing you to do is basically
push the wrist down slightly, tilt away.
Ooh, wow.
And then relax.
Relax.
Yes.
So I'm all about when you're
doing a stretch down, away, hold
for three to five seconds, take
the pressure off and do it again.
I can, I can really feel it.
It's nuts, right?
So does that, oh my god.
Stretch it.
You know that.
So that's stretching the muscles
that you're using all day.
Playing paddle, playing tennis, a
little twist typing on a computer.
So, so if somebody has that issue,
they can do that before they play.
Right before you play, after you play.
Um, and once again, generally, especially
before you play holding the stretch
for short amount of times and doing
many repetitions, you'll get a deeper
stretch and, um, you'll get a deeper
stretch and just, you know, but I think
what's more important is, uh, we talked
about it before, is the biomechanics.
Right?
So if they're having tennis
elbow, well, yeah, likely they,
I think injuries correctly, yeah.
Injuries are prevented by
having the right technique.
It's like anything, you know what I mean?
I, yeah, I was gonna say, when you
guys asked me that in initially,
like I am no paddle expert.
I've taken, I did a lot of paddle clinics
when I was working at Windwood Paddle,
but uh, it is all about technique.
Yeah.
It is all about technique.
That's how you prevent, I
mean, know the best prevention
is, is the technique, right?
Yeah.
So like, coming to you guys and getting
coaches who are watching how you play.
Yeah.
Yeah.
Now, the one thing I know, I
just, I grew up playing sports,
so I know how it is when.
You are, let's say in a tournament and
you're tired and it's the last game.
Sometimes in those moments when like
you're competitive and you wanna win
those techniques that you've gone over
with your coach, they're out the window.
You know, you're like, I'm just trying
to get this ball across the court.
Yeah.
I want it to land, I want it to.
So that's the tough thing, you know,
it's like when you get in those
tournament settings and you're just
trying to win and you wanna Well, but
I think that goes hand in hand with
the, the physical conditioning 1000%
and, and being in shape and all that.
For go for you.
No, I mean, when, like you said, when
the technique goes away, the rest.
You know?
Yes.
You, you get, you, you get
you, you pay sooner or later.
A hundred percent.
You know, lemme ask one
thing, another thing.
It's, uh, when you were talking about the
world pilot tour, the, the professionals
c coming with really lower body mm-hmm.
You know, pain and all that.
What specifically were those
pains and how do you solve them?
Mm-hmm.
Because I, I do, we do get to play and
you feel that heaviness on the legs.
They, they don't move.
They don't react.
Yeah.
You know, the tension on, on
your, so what, what, what, what,
what, what were the issues there?
So, big issue was
cramping when I was there.
Okay.
Huge issue was cramping, but
that could be dehydration.
So since they, I, it was 1000%,
a lot of it was dehydration.
Yeah.
Dehydration.
Not proper supplementation
of electrolytes.
When it's this hot.
And it was also humid
when they played right.
It was like the hot, humid combo.
Yeah, yeah, yeah.
Yeah.
A lot of them were saying
to me, they're like, I'm not
used to playing in this heat.
Right.
They're like, we've played in
the heat, but also remember they
were coming from February Yeah.
In Spain.
It's not, I, no, yeah.
You know, this was a drastic change there.
It was a drastic change for them.
And they had been tr from what
they told me, they're like,
we've been training inside.
Yeah.
In like air condition,
air conditioned places.
No, right in the middle of the winter.
I mean, there you, they, they went,
they, they came from like twenties
and thirties to, to the nineties.
Exactly.
In the Greece, you know?
Exactly.
So dehydration was huge.
Um, and I just think that maybe
a lot of them were like shocked.
They're like, oh, it's February in Miami.
Just like everyone was like,
oh, it's February in Miami.
It's gonna be cool.
Yeah.
And don't get me wrong, we've have
some cool days, but then there's also
some days where I'm like, is it summer?
I don't know.
Right, right.
And so, so you touched
something very important.
You know, electrolytes.
Yes.
So how important are, especially if
we play here in Miami, because we is
drink water and not so much I think.
Why don't we talk a little
bit about electrolytes?
Yeah.
Electrolytes are extremely important.
When you're sweating, you are releasing
like salt in other nutrients, right?
Yeah.
So Miami, a lot of people I don't think
notice it because they, once you get
acclimatized, you don't use, you're
not used to how much you're sweating.
But coming from Canada, myself, when I
first moved here, I was like, oh my God.
I was like tired all day.
Mm-hmm.
I was lethargic.
I was doing my normal exercise that
I had done everywhere else with no
problems and it wasn't, it was because
I wasn't replenishing with electrolytes.
Yeah.
It is so important to replace your salt.
Salt also is a very touchy subject with
people because I'm sure everyone knows,
don't put too much salt in your food.
You gotta be careful.
My cardiologist told me.
Not too much salt.
And don't get me wrong, anyone who has
heart problems, please consult your
cardiologist before taking electrolytes
with a, a large amount of sodium.
Yeah.
But for the normal person, you need
to replenish with salt because you
can drink all the water you want.
If you're outside, sweating, playing,
paddle, sweating all that water
out with nothing to hold it in,
you're gonna dehydrate yourself.
Your muscles are gonna fail and
you're gonna start cramping.
Yeah.
Right.
Yeah.
I, I The salt helps you retain water.
Yeah.
And keeps those muscles feeling light.
Like you said, at the end of a tournament,
your legs are starting to feel heavy.
We need that salt to hold onto that water.
So how do you get the salt there?
Do you use supplements or
you just use simple salt?
Is this salt, certain amount
of salt for each cup of water?
How would you, the electrolytes
do have some type of salt, right?
Yes.
So my, my personal favorite electrolytes
is this brand called Element, or L m N T.
Okay.
Um, it has sodium, magnesium,
and potassium in it.
Potassium.
Another great thing to
help you with cramping.
Um, magnesium also great
for muscle cramping.
And then sodium is great for.
So many different things.
All those things have a lot of benefits.
But no, the big questions
is, it tastes good.
Okay.
Honestly, I think Yes, that's the problem.
I think.
Yes.
I'll tell you a story.
You know, when I was, when I was growing
up, you know, playing, uh, competitive
and, and professional tennis, before
I moved into paddle, uh, our coach
used to eat at, make us eat during
the change of, of size of the corn.
Yeah.
Potato chips and bananas.
Yeah.
For the salt and the potato.
And now that you're mentioning
now, it makes sense a
hundred percent like Exactly.
We're just drinking water.
Cause we didn't have electrolyze,
we didn't have the Gatorades
or anything like that.
Exactly.
So was potato chips and, and, and bananas.
So the pot potassium
is also very important.
Yes.
Yeah.
Super important.
So that's why I love element.
Um, I, there's no sponsorship here at all.
I just love them.
I'll, I'll check it out.
Maybe, maybe.
You good one?
They're great.
Now, be warned, it is when, if
you put it into a drink, it says
between 16 ounces and 32 32.
I, I never know the ounces here.
I'm, I'm a lit person.
Yeah.
Uh, start with a little bit.
They come in these small little packets.
They're very salty.
Okay.
So I would start with
like a quarter of a pack.
Try it out, see if it's good for you.
I like saltiness, so Yeah.
Sometimes I put the full pack when I'm
really feeling it and I need some energy.
Uh, but it tastes delicious.
Okay.
And the best thing about it
is that there's no sugar.
Good.
There's no sugar in it.
Good.
There's just no useless sugar.
Okay.
Gatorade's awesome.
But it has a ton of sugar.
Ton of sugar.
Like way too much sugar.
Yeah.
Than, than you need.
Yeah.
Um, not enough salt.
Yeah.
Element is awesome.
So tell me about those, you know,
the professional players when,
when your, your legs are tired.
Where, what, what will be the
right thing to do right after?
So definitely stretching.
Okay.
Now when, when I mean stretching, I
mean, like I said before when we were
talking about stretching the forearm
stretches that you're holding for a
little bit and then you're releasing,
you're holding for a little bit, and
then you're releasing right after a game
like that when you're like super tight.
Sometimes when you hold them at
end range for a really long time,
like at a full range of stretch,
you can cause, uh, cramping again.
Wow.
So you wanna do light stretching,
especially if you're in a tournament,
stretching is great, but you also have
to be careful stretching too much.
You can pull muscles too far.
Right?
Yeah.
So you have to be in that happy
medium of like a little bit of
a stretch, but nothing crazy.
You shouldn't be stretching and
being like, Ooh, this hurts.
You should have that nice feeling
of like, oh, this feels nice.
I need to like lengthen this muscle.
Let, lemme ask.
So what do you recommend?
I mean, um, some people recommend
stretching before mm-hmm.
Or after or both?
Ideally.
Ideally I would recommend
an active warmup beforehand.
Now.
So activation.
That's what Activation, yeah.
That's my personal professional
opinion is activation before, yeah.
A little light stretching,
not gonna hurt you before.
Yeah.
But ideally stretching afterwards.
Sometimes my, I have patients who are
like, I really wanna stretch before,
and I tell them, how about instead
of stretching, you do foam rolling.
Oh.
Same kind of idea.
That's after the match.
Before.
Oh, before?
Uh, wrong.
Okay.
Alright.
I love foam rolling before it's,
Not stretching, but you are
also lengthening the muscles.
You're bringing blood to the area,
you're getting loose for the game.
Um, and foam rolling.
You have to be active.
You, you know, you're rolling
up and down so you're not
stationary for a super long time.
Um, so when patients tell me, they're
like, I really wanna stretch before
I'm like, stretch, but maybe do
foam rolling instead of traditional
stretching and save the more
traditional stretching for the end.
Good.
Uh, now when those players
were getting actual cramps Yes.
What was the solution there
to resolve it very quickly?
Yeah, because they have
to still play, right?
A hundred percent.
So honestly, I went outside and
asked someone for a banana and a
Gatorade, cuz that's what they,
uh, I can't remember, was Gatorade.
Whatever the electrolytes that
that wa the, the drink that I had
there, the drink that they had
there that was sponsoring them.
Um, and then basically what
we did was soft tissue work.
So I don't wanna say it's like massage it.
It's uh, active release therapy.
So you kind of are pinning down
the muscle, stretching a little
bit, pinning down the muscle,
stretching a little bit, trying to
pump the built up lactic acid out.
Um, but the banana and the
electrolytes were key as well.
So how, how quick does that work?
I mean, uh, very quickly you'd have
to go and play, you know, is it like
five minutes, few minutes, or, uh,
I would say like five, 10 minutes.
Wow.
Yeah.
Wow.
So that's key when, if you're getting,
uh, cramps right in the tournament?
Yep, definitely.
Oh my God.
Super key.
The best thing was though, most p uh,
most of the players, even if they were
playing after they had a couple of
hours in between their next, next, next
match, it was rarely, I think I had one.
One, uh, team that they like.
We, they came in, they're like, we have 20
minutes and we have to get back out there.
And I was like, okay.
Mm-hmm.
And then at that point you're
like, all right, I'm rushing.
So, so let's talk about another injury.
Uh, that's something that you
see, uh, more often, uh, when
it comes to paddle players.
Okay.
Uh, shoulder, shoulder's huge.
That's my problem.
Okay.
Shoulder.
Shoulder is huge.
Yeah.
Shoulder's huge for so
many different sports.
Even fricking weightlifting is huge.
Yeah.
Um, yeah.
A big one is gonna be impingement syndrome
and exactly where you're pointing,
like the front of your shoulder here.
Yeah.
A lot of people struggle from,
uh, impingement syndrome.
And basically what that is, is crowding.
You're using something a lot.
So paddle, using your shoulder a lot,
tennis, using your shoulder a lot.
Um, overuse of the muscles.
Right.
And then the, the tendons
in here tend to get a little
crowded and that can cause pain.
Okay.
Right, so the idea is you wanna loosen
up all the rotator cuff muscles and all
of the shoulder accessory muscles that
surround that region so that the tendons
aren't crowding so much and they can
have their own space to move around.
The other difficult part about the
shoulder is in this entire region,
from here to down here, you have
a lot of nerves coming from your
neck, traveling into your arm.
So impingement syndrome, when you
have those tendons starting to get
compressed, they're gonna start
compressing on nerves as well.
That's why it can be so painful sometimes.
Mm-hmm.
And it's a lot of the time people
point right here as the area that
they feel the pain, but really what's
going on is there's a muscle in the
back of the shoulder that's irritated.
There's a muscle that's in your armpit
called your Subscap that's irritated.
You have one on the top
here that's irritated.
A lot of them attach up here.
So that's why a lot of
people will feel it here.
But the actual source of pain
is in the back of the shoulder.
Interesting.
Yeah.
And that's, and that's where
you try to do the work.
Do the work.
Yes.
I've heard you have to find out
where it is, where it's coming from.
Of course.
So you take through a whole orthopedic
exam and listen, I'm just telling
you about impingement syndrome.
There's rotator cuff tears,
there's labral tears.
Oops.
Um, there's so many shoulder injuries.
Yeah, it's nuts.
So, and, and what will be the
treatment is first of all find
out and then take care of it.
Yep.
What will, we're going
back prevention technique.
Same thing.
Right?
Technique.
And I mean, having the proper technique
for the sport that you're doing,
especially paddle proper technique,
but also super important, right?
Is people who are playing a
lot of paddle, you gotta do
some cross-training, you know?
Yeah.
You gotta do some, whether it's personal
training with lifting weights safely.
Of course.
Yeah.
Cuz you can also injure yourself that way.
But you know, you're gonna build up
strength in those areas so that they don't
fatigue as often so that you don't have
to use accessory muscles to hit the ball.
And then you're gonna prevent
injuries that way as well.
So, technique, uh, strength
training and cross-training just.
Any other way, you know?
Yeah.
Do we be doing cardio
different ways or so?
So what exercises can they do at home, uh,
to loosen up that shoulder if something?
Oh my gosh.
Something that most paddle players
have really tight is their peck muscle.
So I'm sure everyone has heard about
the stretch where you're standing in
a doorway, you're gonna put your arm
at 90 degrees, you're gonna have the
doorway block, essentially your arm
here, and you step forward and it kind of
stretches the front of your chest here.
That is a big one for
people with shoulder issues.
Um, Oh my gosh.
There's, I mean, there's so many stretches
and exercises, but that's this one, right?
That's probably the easiest one.
I know.
That's the easiest one to just
like describe on camera right now.
Okay.
Let me ask one thing.
I think this will be crucial
if we can go to your clinic
and then show us some of those.
Oh my gosh, exercises.
Yes.
I would love you guys to think you would
be very, very important for, for, to
show to our views and, and audience.
A hundred percent, you know, just
go through the different, uh, drills
on, you know, hundred things that
we can do to, to prevent that.
So let me ask one thing.
When it becomes, when
does it become chronic?
So, textbooks will tell you
that one to, I think it's five
days, it might be three days.
I'm gonna say five.
One to five days is an acute injury.
If you've got no pain after like,
uh, one to five, the, the injury
and the injury is essentially
gone after that, uh, you're good.
Chronic, real chronic injuries
are when, in my professional
opinion, they, uh, surpass a month.
Six weeks of pain.
I'm like, all right.
Wow.
And they've tried a few things.
They're like, okay, you know, like I tried
hot and cold, I tried stretching, I tried
all these other things with no relief.
And then I'm like, all right,
we got a chronic issue.
Um, and how do you get rid of
the chronic issue treatment?
So you gotta go through the same things.
Yes.
More long-term, more long-term treatment.
It's not gonna be as a quick a fix,
but as great as treatment is, and as
necessary as it is, if you're not doing
the homework that we prescribe you
to do at ho like to do on your own,
it's gonna take much longer to heal.
Right.
I always give, I try to give most
of my patients a lot of exercise.
I do have some patients that are
like, listen, I'm not gonna do this.
And I'm like, okay.
Um, but if you can, and I try
most of the time to give exercises
that are easy to do, easy to do.
You don't need a ton of equipment.
But if you're doing that at home,
easier to get better faster.
Another thing that is super,
uh, necessary for recovery,
especially in chronic issues.
Sleep.
Wow.
If you are not getting good
sleep, your body does not have
the time it needs to heal.
Wow.
So if you're not getting good sleep at
night, you're, you can still get better.
It's just gonna take so much longer.
Like uninterrupted sleep.
Right.
Uninterrupted sleep for 70 hours.
I'm a hundred per, exactly.
Like I totally understand.
When people have new kids,
that's essentially impossible.
I know that.
But if you are someone who has the
opportunity to have un uninterrupted
sleep and get the 78 hours, it
is going to be a game changer.
And same thing with people
who are in tournaments.
So say you're playing
Friday, Saturday, Sunday.
Yeah.
Those nights in between the days, you
should be getting some seriously good.
If you wanna be playing good the
next day and you want your body
to recycle all that lactic acid
buildup, sleep, that's beautiful.
Sleep True.
It's like honestly, one, it's so
important and no one ever talks
about it, but it's so important.
Yeah.
Pamela, let me ask, uh, um, It's one thing
that now is, it's becoming very trendy.
Cold therapy.
Cryo cryotherapy.
You knew I was gonna get asked
this, so tell, tell us about it.
It's a good, I mean this cold bath or the
cryo, is it cryotherapy that you call?
So there's cryotherapy and
then there's cold plunging.
I personally have never done cryotherapy.
Same idea though.
Um, it's great.
Okay.
It's what is, what reduces
this infl, the inflammation.
So especially for paddle and what
we're probably using it for is
reducing inflammation, right?
When you go into anything cold, so a
cold plunge or the cryotherapy chambers,
what you're gonna do is, uh, your blood
vessels are going to constrict, right?
Your blood is gonna rush to the center of
your body to keep your organs warm, right?
So that's gonna help with all the
joints, your shoulders, your elbows,
nip, neck, knees, hips, all that stuff.
Um, and then when you get out, Your
blood vessels are gonna dilate again
and new fresh blood is gonna come to
that area to help heal all the tissue.
So that's the theory of it, right?
Yes.
Wow.
It's a theory or it works?
No, it definitely works.
I mean, there's a lot of
research that says it works.
Okay.
A lot of EV evidence-based
therapies or research papers that
say it works, do you recommend it?
Yes.
And do you have to do your whole body
or can you just do like your face?
Cuz I seen that, you know, I mean, no.
Your face, no.
I mean only if you when get
treated certain areas or, yeah.
So I personally say going I,
I tell my patients, if you can
go up to your neck, gotcha.
Right.
Go up to your neck.
You can get all the joints.
I mean, if you're going in there anyways.
Yeah.
Right, right, right.
Why not get the benefit for
all the areas, you know?
Yeah.
I do say though, best to do
it after playing Right after.
It could be right after.
It could be a few hours after.
Okay.
The reason I say after is because
you know you're gonna get cold after.
And you wanna go into a game warmed up.
Okay.
Gotcha.
Being warm.
Like, that's just when you
asked me about stretching.
Yeah.
And I said I prefer doing active warmup
versus stretching before starting.
You wanna go into a
game warm, ready to go.
Um, so personal, professional
opinion, cold plunge after you play.
Wow.
Yeah.
Have you ever done that?
No, but I've, I've been,
I've been, me neither.
I don't know if wondering to do it.
I mean, a lot of my friends, they have
done it and they said it's fantastic.
It's amazing.
I mean, they, they did a cry on the,
the colan so you can stay longer.
The cry is, I think it's
like a minute or two.
Yeah.
That it's like drops to like 120 below.
Wow.
And it's like, but yes.
You feel rejuvenated.
Oh my gosh.
When you, when you leave
that thing after two minutes.
Wow.
So I work, um, I work at a,
currently the clinic I work out
of, I work for USA Sports Medicine.
Right.
Um, and they have clinics
all over South Florida.
Uh, and the spot that I'm
in is in the anatomy gyms.
I'm not sure if you guys have seen them.
Oh.
They have gyms in, I think South Beach.
Midtown, I'm in the one in Coconut
Grove, and they just open one inre.
Wow.
Okay.
Let's, let's talk about a little bit.
So, uh, explain, let's talk about
a little bit about your company and
where you're located and, and Oh, okay.
Yeah.
Um, so, uh, I've totally
forgot about that.
I work for U S USA Sports Medicine.
Uh, it's an awesome company.
We have chiropractor, chiropractors,
physical therapists, uh,
regenerative medicine doc.
Uh, we have a concierge doc, Dr.
Singh.
Yep.
Um, we have a podiatrist.
We have, um, there's also another
separate sister company called App Prize
Medical and, and a prize aesthetics,
um, that deals more with, um, I don't
wanna say beauty, but that's Yeah.
A beauty aspect of it.
Yeah.
Okay.
Right.
Um, but the company I work
for is USA Sports Medicine.
Um, where are you located?
I'm in Coconut Grove.
Me personally.
Okay.
But we have clinics all over South
Florida, so we have two flagship offices.
One in South Beach where my husband
works and one in, uh, Aventura.
Okay.
And that is like a very
traditional looking like clinic.
They have like a rehab floor,
you have separate rooms to go in.
Um, where I work is more of a satellite
clinic, or I have like my small room,
I've got a couple tables and I've
got all the supplies I need in there.
And it's just me, my
assistant, and the patients.
Beautiful.
And you said it's within the anatomy gym?
I'm inside the anatomy gym.
Yeah.
And you don't have to be a member
to come and get treatment there.
Okay.
But the reason why I brought
it up in the first place is
because they have a cold plunge.
Oh, okay.
In their facilities.
Yes.
So sometimes when I have a long day is
that cold plunge meaning ice with water.
I, it's literally a hot,
looks like a hot tub.
But it's freezing.
Okay.
I think right now it's
sitting at 38 Fahrenheit.
So what tempera do you do?
You need to be, uh, to, for it to work?
So really anything below 50 is what I,
what I've read below 50 is, some people
say colder the better, but this, the
research says if you're doing it like
realistically under 48, let's say.
Okay, 48 or under, I'm under 48.
Cause I dunno if I can
go any lower or not.
Honestly, at that point, it's so cold.
I tell patients, I'm like, but do
you see, you have to be a member?
No.
So for the cold plunge you do.
Oh, if don't see me, you
don't have to be a member.
Okay, good.
Yes.
And then you're gonna leave us the
contact, we're gonna put it right below.
So for people to contact you on
the, the website and all that.
Hundred percent.
So let's talk about the back.
Right?
Okay.
Yes.
Low and back.
Yes.
My bread and butter.
The back.
Right.
Because I see a lot of that.
I, I'm sure you see a lot of
paddle players come in for that.
And what do you see and uh, how do you
resolve that or, so biggest thing I've
seen with paddle players is, uh, depending
on what side your forearm is, because.
Generally you hit forum
most or that's at least try.
Most people's you try to
right strongest that way.
Mm-hmm.
Most people, um, is the side that
they hit forearm with is the side
that they have low back pain.
Right.
Oh, because imagine
that's a ton of rotation.
You know, when you're hitting,
you're always rotating from the
trunk a little bit at least.
Um, and what people don't know is that
rotation with a little bit of flexion,
which is bending forward, is when
your spine is at its most vulnerable.
So you're right, paddle players have
a lot of back pain and that's because
of the rotation and the flexion.
And imagine adding torque
to that, right, right.
When you're hitting the ball.
So ways to relieve that.
Stretching soft tissue work
exercises to make the back stronger.
Um, when they come in and see me, I do
a lot of decompression therapy, which
essentially is just trying to separate the
vertebrae, um, to give them some space,
stretch out the muscles along the spine.
Um, And how do you do that?
I have a very fun table in there.
Yes.
A torture table.
I've seen it.
A torture table, but it
feels amazing after it.
Yeah, yeah, yeah, yeah, yeah.
Um, it's a little bit
medieval, but it feels awesome.
Well, what can they do at home?
Like somebody has a back, back pain.
What, what, what can they do?
Rehab exercises and stretches.
Okay.
Sciatic nerve.
Yes.
Which we all get quite a lot.
Yes.
I have a lot of patience with that.
Causes and prevention and cures.
And why do you get it?
Okay.
And is it, you know, a muscle or is
it the actual, it could be herniated
This, what, what are all the, because
that, that all feels almost the same.
So, answering my question for
me, um, it, so sciatica, right?
Sciatic nerve sciatica.
Yeah.
That's when you got radiation
to pain down the leg.
Yes.
Kind of feel in the back and then boom,
it's starting to shoot down your leg.
True.
Sciatica is when you have a nerve in
your, uh, nerve in your back compressed.
And then it goes down into your glutes
and goes down into your leg, right?
Sciatica can come about
from a few different ways.
Um, most, like I said, most time a
nerve gets compressed in your back.
If you're between the ages of 30 and
50 30, and let's be, let's say 30 and
60, uh, the most common cause of true
sciatica, and I'll say what I mean by true
sciatica after is, uh, a disc herniation.
So that disc pops out and compresses
on the nerve and it's starting
to send pain down the leg.
Right.
And pops out is not the right
term, but you know what I mean.
With her, it comes out.
It's like herniated.
It slips out.
Yeah.
Yeah.
Starts pressing on some
nerves causes irritation.
The reason why I keep saying true
sciatica is because people can get
sciatica like symptoms that is not
actually a nerve or a disc herniation.
Uh, you can get something
called pure forma syndrome.
What that is, is there's a muscle
in your glute called your perfor.
It's an external rotator of
your hip when it tightens.
It sits on top of the sciatic nerve.
So when it gets tight and compressed,
it can start to push on that sciatic
nerve and then that sciatic nerve
will send the pain down the leg.
So how do you, at home, how
would you get rid of that?
Well, it depends on if it's true
sciatica or if it's pure form syndrome.
Yeah, that one.
The muscle one.
The muscle one.
So foam rolling on the glute foam rolling.
1000 glu on the glute.
On the glute.
Okay.
Foam rolling on the glute.
No.
What actually, in the back where
the pink is coming from the, of the
right on the glute, if you have true
sciatica, it's much more complicated.
But how can you tell which one is which?
You have to go in and get a, get it.
Oh, okay.
Yeah.
Even me, sometimes you have to like the,
you take someone through a, a serious,
uh, neurological and physical exam to
tell them like, okay, you have a herniated
disc, or you've got perfor syndrome.
Another thing that can cause sciatic
like symptoms is joint dysfunction.
So just meaning, uh, improper motion
in your joint, in your sacroiliac
joint, which is also in your low
back, right above your glute.
Okay, so Well, if it's a muscle and it's
timed up, eventually after a few days
when it loosens up, you should technically
no longer feel that pain, right?
Yes.
That's kind of how you'd know.
Maybe it's not a herniated disc, right?
Yes.
So exactly.
Because a herniated disc is gonna
be painful I think all the time.
Never goes away, right?
All the time.
Yeah.
So the foam roller will
be option number one.
Foam roller would be option number one.
You're like, Ooh, I'm having pain
down the legs kind of starting in my
low back, but I feel it in my glute.
Let me roll on my glutes.
So what are you actually
trying to roll it?
Rolling off some of your muscles
with With a foam roller, right?
Foam roller.
Yep.
Loosening it up and Exactly.
Loosen it up.
You're trying to get
any knots out of there.
You're trying to take some
pressure off that sciatic nerve.
Um, that could be causing the sciatic
like symptoms cold and all that.
That doesn't do anything.
It could be helpful.
It could be helpful cuz maybe
that muscle is tight, maybe
it's a little bit overworked.
We have a little inflammation there.
Always try it cold.
Yeah, in the hot tub jacuzzi or something.
Sometimes I tell patients, I'm like,
if it's really bad, try ibuprofen.
But Pamela, all the things that
you're telling me is more moving
towards the physical therapist.
We haven't cracked anyone yet, so Yes.
How, how do you, can you crack someone
and fix the, the sciatica or, oh my gosh.
So if you have, or the
elbow, the shoulder.
So if you have true sciatica, definitely.
Maybe not.
Maybe if you come in and it's like a
hot, we call it a hot disc, meaning like
you have sharp shooting pain all the
way down to the bottom of your foot.
Walking hurts.
Sitting hurts, everything hurts, right?
Yeah.
And it's agony, like
completely unbearable.
I won't be adjusting you on
day one, that's for sure.
You won't be able to get into the
position that I need you to, but once
we get that pain to come down a bit,
so what, what do you do with adjusting?
We, what you're trying to do
is restore proper joint motion.
Okay?
When your joints are stuck and they aren't
moving properly, they're gonna cause so
much more pressure to the system, right?
The reason why adjusting is a
great tool is because it provides
a quick stretch to the muscle.
You help restore proper joint
motion that you used to have there.
And for whatever reason, whether your
muscles are tight, whether you've got
inflammation in the area, whatever caused
those joints to stop moving, um, you
are gonna help release that tension.
Adjustments also help, uh, they give
you kind of like an analgesic effect
after you get the adjustment done.
Um, so it can be super
helpful in that regard.
But when you have tru sciatica and it's
going all the way down, ideally I want
the pain levels to come down a little bit.
Once you come in, you're like, I still
have it, but like, it's more bearable
now, then I'm gonna start adjusting you.
Okay.
So, okay, perfect.
I'm still gonna do soft tissue work.
Oh yeah.
So anytime a patient comes in, I do
soft tissue work and if they are a
candidate for adjustments, because some
people aren't, should not be adjusted.
Depending on if they have osteopenia,
osteoporosis, depending on if
they have other health conditions.
Um, can you hurt someone by
adjusting them a hundred percent.
But just like you can hurt someone going
to a massage doing soft tissue work.
So that's why you do, you do exercises.
Yeah, yeah.
Doing exercises wrong, you can
get hurt so many different ways.
So no.
Is there a point where you, you, you
say to your client, well, you know, I
think, I think it's, you may have to have
surgery, you know, like in a herniated
disc or something where uh, physical
therapy is not, or chiropractic is not
gonna help, is there a certain point
where you feel like, okay, this is needs,
uh, surgery or, or something like that?
A thousand percent.
There's always a time, there's
a time and a place for surgery.
But what I tell all of my patients
is surgery is irreversible.
You can't, once it's done, it's done.
I tell them, you need to
try absolutely everything.
I don't care if it's me.
I don't care if it's, you're
going to someone who does energy
healing, whatever it is, right?
If something helps get rid of
your pain and you don't have to
go through surgery that Oh yeah.
If you can avoid surgery, yeah.
You're better off.
Amazing.
Exactly.
But there is always a
time and a place for it.
Yeah.
There's times where I'm like, listen, this
point of no return, point of no return,
but I will let you know about 60 to 80%
of disc herniations resorb naturally.
Really?
Wow.
I didn't know that.
However, it takes a long time.
People, it takes a long time
and people don't wanna wait.
Yeah.
If people go in for consistent therapy,
they'll say three to six months.
Which is awesome.
The thing people don't realize about
surgery is once you get the surgery,
you still have to go to rehab.
Yeah, yeah.
You're still gonna be going to
rehab for three to six months after.
Yeah.
So, and they, and they, it's a, that,
that's a very risky operation too.
It's super risky.
So they, they can guarantee you
a hundred percent no guarantee.
I have a few patients that I see can,
on a consistent basis, snout, and it's
because they went in for surgery and
the pain that they went in for is gone.
But because of the surgery, they
now have pain in other regions
and there's no other way to fix
it than going in for more surgery.
Wow.
Do you know what I mean?
Yeah.
Then they all say, they're like, listen,
if I can do this once a week and it
keeps me feeling good and I can still
do the stuff that I wanna do, I'd rather
do this than go back into surgery.
And then, who knows, maybe it
works, maybe it causes other
issues, X, Y, and Z, you know?
Fantastic.
I, I, I just love that.
I mean, it's extremely helpful.
So listeners, you know,
everyone that is watching.
She's the one.
If something hurts, you
gotta go and see Pamela.
Oh yes, she come on in.
She fix all your problems.
So then all your pains.
So another area I think people
get, uh, have problems with is
their shoulders and their ankles.
Right.
So, uh, ankles.
Ankles.
So I was gonna say, when I was
at the World World Paddle Tour,
that's something I saw a lot of.
Wow.
Well really?
Yes.
You mean sprained ankles?
Yep.
So something that I was not aware of
when I signed up for the tour, uh, not
signed up, but when they were like, oh,
you're gonna do it, I was like, cool.
Um, I didn't know the rules that
like if someone has an injury
on the court, there's like only
a certain amount of time Yes.
That you can stop.
Mm-hmm.
And do like the taping and stuff.
Okay.
So in school, the school, at least I went
to you learn how to do sprained ankle
taping, all different types of taping.
You learn how to do,
but we're not own pace.
Pardon?
At my own pace.
Yeah.
But you're not time.
Yeah.
You're not timed.
Yeah.
So that was a shock.
I remember being out there.
Sweating boxes and I was like
going as fast as I could.
I had like some other, uh, colleagues
and uh, physios and people out
there with me and like telling you
30 seconds left, 45 seconds left.
Yeah.
Like, yeah.
Rough.
I didn't realize that.
But yeah, there was a lot
of sprained ankles that day.
Once again, I don't know if it
was the heat that caused that.
Another thing that I was not expecting.
Lots of sprained ankles.
Yeah.
I can't even tell you
how many ankles I taped.
A lot.
Well, in, in paddle and tennis,
you have a lot of lateral movement.
I was gonna say a of quick reactions
on lateral movements and that's.
The ankles.
Mm-hmm.
One of the things, actually, as a matter
of fact, uh, when I, what I see on my
students, it's, they come and play.
One of the issues they have is they
come and play Paddle with running shoes.
Yes.
And that's the worst
you can do if you wanna.
That's me.
Yes.
I did that when I started.
You can really hurt yourself.
Yeah.
You know, uh, playing
with, with running shoes.
I believe it.
Yeah.
I believe it.
Yeah.
I, I said the other day, yeah.
This Lady Falls, has running shoes.
Oh, really?
All on the ground.
Yeah.
I'm like, oh, man.
I know, you know, you could twist
your ankle easily because usually
the, those shoes are a little higher.
Right.
Well, imagine running shoes.
There's support left or right.
They, they have all those
like curves and mm-hmm.
Support in certain areas depending
on what type of running you're doing.
Yeah, exactly.
Yeah.
So that makes a ton of sense.
Yeah.
But achilles also huge, huge area.
Yeah.
That, uh, for paddle players,
I have a patient who achilles,
it's, is it a tendon or a muscle?
Tendon.
Okay.
But your calf muscle, your calf muscles,
you have a soleus and a gastro anemia,
two muscles of the back of the calf.
Right.
Um, those, can you repeat those names?
I like, sounds very, uh, exotic.
Yes, they do.
So exotic.
Uh, so the traditional calf muscle
that most people think makes
up your calf is your gastro.
Okay.
And then there's actually a muscle behind
it that also contributes to your calf.
It's called your soleus.
Okay.
Yes.
So, and those are connected
to the achilles tendon.
They essentially kind of turn
into the achilles tendon.
So it will, it's like
muscle, muscle, muscle.
And then there's like a transition
segment where it starts to turn
into a more tendonous portion.
And then it turns into
the Achilles center.
So what do you see happening
with, uh, paddle players there?
Well, I had a patient come in
recently and he was telling me, he
was like, I was playing and this
is someone who has played forever.
He used to be a professional.
I remember come paddle.
I'm not gonna say his name, I
just don't know if I should.
Yes.
But yes, not, I'm sure he wouldn't care.
But he was telling me he like ran
up to the glass and he like, put,
so if this is the glass mm-hmm.
He like put his foot up to stop him.
He like put his foot up against
the glass and he like felt a
hole and the achilles tendon.
Right.
Wow.
He came in, it wasn't a, it wasn't a tear.
Like he may definitely wasn't a tear.
Cuz if that happens at a tear,
it's that it's broken completely.
So you, you can have partial tear.
Okay.
You can have a partial tear.
Right.
Yeah.
If that happens, and for someone
like him who I know is like,
I wanna get back AAP p mm-hmm.
I'm sending him to Dr.
Veran and getting a P R P
stem cell, whatever he decides
is best for that patient.
Um, But he just did a light lucky.
He was super lucky.
He did a light pull to
his, his calf muscle.
But if you have pain in one of those calf
muscles, it can start to go down and you
start to feel in your achilles tendon.
Right?
Because the two are super
intimately connected.
Um, but achilles tendon is a rough,
if you have a full Achilles tendon
tear, that's surgery, surgery,
that, that there's no way around.
Wow.
So, and that's when they have to open.
And they have, and, and what happens
if you, if, if it breaks completely,
you can walk or you can, you can
walk, but like, um, you have no
spring, zero spring in your foot.
Okay.
So, you know, when you walk, it
kind of like propels you forward.
Like even when you're barefoot, your foot
kind of has that like, When you Heel toe.
Heel toe.
Yes.
Yeah.
It is hard to do that sign.
So that's where the, it kind of looks
like your head, your hand, you know, your
foot, like hangs like this kind of Yeah.
Your foot would, is gonna be like this.
Wow.
Is that where the mythological
story comes from, from Achilles
was defeated your Achilles heel?
Yes.
Yeah.
When he, he got shot in the Achilles by an
arrow and then he couldn't keep fighting.
Is that, is that where it comes from?
I, I think so.
Okay.
I don't quote me on that.
I don't know.
Greek mythology, I, I think that's where
it's come from, that kill his heel.
Mm-hmm.
Uh, that's super interesting.
And what, what is, if he's stare,
what is the treatment for it?
So, okay, now I say, I mean
you have to be very careful
because you can break it, right?
Yeah.
So you don't want to go that,
so, so breaking it, how, what,
what is the recovery time?
Like, the full tear?
Yeah.
So once again, I have to
ask Lee, check with Dr.
Porin.
If he can't, I, I'm not sure.
I'm pretty sure if there's a full
tear, he, you go to surgery, but.
I think it depends, cuz I think
he has done some stem cell
injections in some people.
Wow.
That have close to a full
tear and they've gone.
Wow.
Yeah.
That's awesome.
Um, but that part I have to
double check on actually.
Um, but if you have a full tear and
let's say you go the surgery route,
um, you, they're gonna essentially
sew it back to get back together.
Um, and then from there
it is painful long search.
It is, sorry, long rehab like you
are, it is a lot of rehabilitation.
So you mentioned stem cell.
Can you talk to our viewers
a little bit about that?
Yeah.
Stem cell is, uh, everyone has
stem cells in their body, right?
It's what, how all of our current
cells came to be what they are.
You started a stem cell and then it
proliferates and turns into a skin cell
or, uh, a heart cell, a blood cell.
You know, we, as we get older, you have
less and less stem cells available.
So when a patient is going to get stem
cell therapy, a big thing to ask whoever
is providing it, you should go see Dr.
Povera.
He's awesome.
Whoever's providing it, you gotta
double check that you're, they are
gonna be using your own stem cells.
Your stem cells are going to help
you heal fastest than anyone else.
Stem cells, sorry.
Some places will give you umbilical cells
or something called Wharton's jelly,
which is essentially just stem cells from
someone else, whether it's another human
or another mammal, or if I'm not mistaken,
they're now starting trying to make them,
uh, chemically, or what's the right word?
Synthetic.
Synthetic.
Synthetic.
Sorry, that was the word I'm looking for.
Synthetic.
That's right.
Now some of the people, they ask you
when you have a baby to, uh, Safeguard
the umbilical cord because of the stem
cells to pre, pre to pre preserve.
I, I, I think that's what it is to
preserve the umbilical cord from
what I understand, that's part of it.
Yes.
Okay.
Once again, don't quote me on that.
Not an expert in that particular realm.
Um, but that's why you wanna make sure
when you go to your doctor that you
are using your own stem cells, because,
so how do you, so how do you do that?
How do you get your own stem cells?
All right.
So places you have stem cells,
your hip bones, your ileum, these
like where you can feel the top
of your hips on your side here.
Yeah.
Yeah.
Basically what they do is they
drill a hole into the hip and
then suck it out like that.
Wow.
Wow.
And, uh, not the most comfortable
procedure from what I understand.
I haven't had it ton.
And then they inject it again, or they
have to go through a, a specific process.
So they'll take it out.
They essentially process the stem
cells, and then they're gonna inject it
into, let's say, your Achilles tendon.
We were just talking about.
They're gonna inject it right
into the achilles tendon,
wherever you need it done.
Wow.
So how about the farmed, uh, um,
stem cells and is that inferior
or does that work the same way?
I mean, from what I have seen,
I have heard, and the research
papers say the, it is not as good.
Okay.
It is always better to use your own, cuz
your body knows what cells to change into.
That's a good cool thing about stem cells.
It's like, oh, I'm gonna put you in
my achilles tendon and I want you
to turn into Achilles tendon cells.
Wow.
If it's your own stem cells,
you already knows your body's
program to, to become that.
So when it's someone else's, don't get
me wrong, I've had some people have
some, they told me they had some success
with, uh, the umbilical stem cells
that is someone else's or the oranges
jelly, but not to the same extent.
Okay.
So because it's a, it's a new
substance coming into your
body and your body's like, Hmm.
Just like when someone gets a
transplant and they're like, Ooh,
let's see if this is gonna, the
body will accept or reject it.
Right.
Same thing with the stem cells.
Mm-hmm.
You want, you don't know if
someone else's stem cells are
going to, it's not guaranteed.
It may or may not stick.
Right.
Exactly.
So that's why you always best if
you're gonna be looking into stem cell
therapy, that you are using your own.
So what's the difficulty in stem
cell, some cell therapy and P
R P when you're using a, at,
let's just say, uh, an injury.
Mm-hmm.
So that is definitely a
better question for Dr.
Pve, but from what I understand, which,
who could be, he could be a really
cool person to have on the podcast too.
Yeah.
Um, depend.
I do know that he likes to do
p r P on lateral epicondylitis,
paddle slash tennis elbow.
Okay.
Lots of good results there.
I don't wanna, I don't wanna answer that
question cause I'm, I feel like I'm gonna
say it wrong, but, uh, the difference is
essentially you're just getting blood.
P RRP is platelet rich plasma, right?
Mm-hmm.
So you're just getting your platelets.
And your plasma from your blood,
which once again came from stem
stem cells in the beginning.
That's incredible.
I mean that, that would be extremely
helpful for me to recommend
to my students when they come
from with tennis elbow injury.
And it works because I've
had that done already.
Yeah.
Yeah.
My foot.
And it's uh, I mean it is painful,
you know, when check it in, but it's
more painful that have for six, seven
months at turns elbow and then you get
irritated playing like you can't play.
Right.
It makes it rec the recovery so much fast.
So if you wanna get out there and play
again, I mean that's maybe, I mean,
Whitney, you said you played it yesterday.
Yeah, well I mean, you know, it was easy.
I know, you know, still, still.
But the thing that I'm like, uh,
you know, really excited about that.
Like I can walk and I can, cause when
that happened I thought I was, wasn't
gonna walk for a month at least.
At least.
And I'll be two, three months out.
I feel, I think I got, I think a couple
weeks and then I think I could play like,
not a hundred percent, but almost there.
Yeah.
You know?
Yeah.
And like no matter what injury you
had, even if you didn't go to the p
r P route, no matter what injury you
have, Let's say you are out for three
months, like you thought without the p
r p the first couple games back, you're
still not gonna be a hundred percent.
You know what I mean?
Right, right.
So that's normal.
Right.
But that's the fact that you're
doing this, what, a couple
weeks later is incredible.
So when would you consider
doing p r p when it comes
to, uh, a paddle, uh, injury?
So I had another person come
in a couple of weeks ago,
I'm not gonna say their name.
Um, and they came in and
their paddle elbow was so bad.
Like, so bad.
So they came from battle, from Paddle?
Yeah.
They were from Paddle.
Yeah.
Yeah.
Uh, and I was like, listen,
I can do, I can do therapy.
It will get better.
It's gonna take a long time.
I was like, go see Dr.
Porin, get a consult,
talk to him about it.
But I'm telling you, if you wanna
get back to paddle, like as soon as
possible, this is your quickest route.
Yeah.
I am still happy to do treatment if
like, that's what she wanted to and
she wanted to have treatment that day.
I was like, a hundred
percent let's we we'll do it.
I was like, but you need to go see Dr.
Veran.
Did she do it?
Uh, she did.
And what was the result?
You know, you know, I actually
transferred her to South Beach cuz
I'm not at Wynwood much anymore.
Yeah, yeah.
Um, but from what I
understand, she's doing good.
Fantastic.
That's so we have to def
certainly we have to put, uh, Dr.
Preve, what do you Porin?
Yeah.
Porin, yes.
By information right below, I
mean for everyone to reach out
to these guys and all that.
Yeah.
It's, it's honestly what
they do is incredible.
Incredible.
It's also just nice, like I said, to
have another option that's not surgery.
I tell my patients, I'm
like, try everything.
Yeah, yeah, yeah.
Okay.
So now what, what equipment
are are available for.
For players, uh, to use at home to help
with, uh, you know, injuries and so forth.
We haven't, I think you talked about
the, the roller, the foam roller.
Foam roller.
Foam roller is awesome.
Okay.
Uh, lacrosse balls are great.
Okay.
Now one thing, how do you use
lacrosse balls or what, what is,
because they're heavy and round.
Yes.
So they're heavy and round.
So if you have a lacrosse
ball, please be careful.
I've had patients come in with bruises
from using it too aggressively.
And my favorite thing is actually
using a, a paddle or a tennis ball.
And same idea.
So essentially what you do with a
foam roller, same thing, but you
put the ball there so it's a little
more intense than the foam roller.
Gotcha.
Foam roller is more general.
This is better at pinpointing,
like, oh, you got a pinpoint
area that you wanna work on.
I would use the ball versus one more.
And so when you find
it, you'll know, right?
Cuz it hits us spot and you kind of
melts into that spot a little bit.
Gotcha.
That's why I like the tennis ball
cuz it's safe to melt into that
and sit there for a minute and like
relax into the It's a great tip.
I use that all the time once you show me.
It's amazing.
Right.
So it is amazing.
It's amazing the album, it's amazing.
All the different uses that
tennis ball has, right?
Oh my gosh.
It's incredible.
It's amazing.
Yeah.
My dog loves them, you know?
I know.
If you're all you're gonna
use it in the Walker.
Yeah, that's right.
Like I do.
You can use them.
The walker on the cane.
Yeah, that's right.
They do use them on the cane.
My grandma had that.
Yeah.
Oh my gosh.
That's funny.
Right?
Uh, okay, so anything
else or, yeah, for sure.
Um, thera Gun or Hyper Volt.
Those like massage guns.
Yes, I've seen that.
How good is that?
I was gonna ask you about that.
The famous, the Gun and all the
mimics, they're outside there.
I I was always so close to bite one.
Is it?
Mm-hmm.
Are they really worth it?
I don't think you have to
get the expensive ones.
I, at home we have a hyper volt,
but when Hyper Volts and Thera guns
came out, if you were like, um, a
therapist of any sort, they gave you
like a discount code when they first
came out to help popularize them.
Yeah.
So I got mine like for a
very affordable amount.
Um, they are great.
You don't have to get
the most expensive one.
They're all gonna do the same thing.
What do they do specifically?
I just like them to, if you
got tight muscles feeling tight
after a match, they're great.
Really something that I
So just do the, that's it.
Like if you got a knot somewhere?
Exactly.
Or, or, now one thing about these
guns that I don't like, for example,
if someone has a disc herniation and
they're like, oh, my back is sore.
Oh no, I'm gonna put the gun on my back.
Oh no.
Yeah.
That is a no.
Okay.
Tight muscles.
They're great.
If you have an actual injury, like
let's say sciatica, sciatica, sciatica,
it would be good to do in your glute.
Okay.
It would be good to do down
your leg, but right in the back.
Forget.
No.
Especially if it's a herniated disc,
especially if it's a herniated disc.
You don't need to be
hyper volt in that area.
Vibrate your, your low back
or your spine in general is
super sensitive to vibration.
So imagine shoulder pain.
Shoulder pain is good.
Once again, let's say you're
having sharp pain here.
Don't go hitting the thera
gun and the sharp pain here.
You wanna do all the muscles
that surround the shoulder.
If you're, I always explain it as,
imagine you had a cut on your arm.
Right?
You're not gonna go and, and they
say like, the gun would help that.
Right?
You're not gonna go
hit the cut right here.
You're the wound will have
no, no chance to close, right?
Yeah.
So let's say you pulled a muscle, it's
the exact same as like cutting your skin.
You have a wound there.
If you're just hitting the wound over
and over and over again, you're having
no chance for that wound to heal.
Yeah.
Now all the muscles that surround
that area that are now tightening
up because you have to compensate.
Those areas are safe for sure to
use the Thera gun, but using it
directly on the area, especially
if you have a spot that's sharp
shooting pain, do not thera on there.
Okay.
So people, so what would
you do to the tennis elbow?
Let's say my elbow is hurting.
Mm-hmm.
So where, where should I do it?
Forearm right here.
So that's it.
Not right on the elbow.
Okay.
Not right on the elbow.
Forearm.
No problem.
Made for the muscle.
You wanna made for the muscle.
Focus on muscle.
Yes.
Don't, you're putting it on tendon.
Yeah.
If you're on the muscle, you're golden.
So from your expert point of view, so
it's recommended to have one at at home.
Oh yeah.
I love it.
I use it at home.
My husband use it at home.
Yeah.
Okay.
We, we have one, we train a
lot, so I use 'em on my calfs.
All the time.
Is there any difference between,
I mean, what is the difference?
The brands?
Yeah.
Thera Guns supposed to be the, the one
every Thera Gun and Hyper Volt are like
the ones that the professionals use.
Okay.
You know, so like in our office we
have Thera Guns, we have hyper volts.
So it's more of a commercial
use you're using all the time.
But if we're just using it
when you injured once in a
while, you may not need that.
Right.
You may not need that.
And, and to be honest, I've used
the ones that are not hyper volt
in their and uh, thera again.
And to me they, they seem the same.
That's maybe they don't have
as many attachment heads.
Maybe they don't, they probably are.
You know what I mean?
I a hundred percent like, I have no idea,
but, and what is the attachment most used?
Is it the Little Bowl or, so I,
because they come with different
ones and they sell you extra ones.
And which one should I get?
Yeah.
So there's one that looks like almost
like a baby tennis ball if you've seen it.
So I kinda like foam fall.
Yeah.
This is, that's a
typical, that's very safe.
Yeah.
One to use if you're wanting to
get a little deeper, you know,
the one that looks like a bullet,
have you seen the little sharp?
It looks kinda like a bullet.
Yeah.
That one's gonna be a
little more aggressive.
Wow.
Yeah.
But, and there're one that
like, like two spikes.
So that one.
The reason they have the two spikes
is you have someone do it for you.
And imagine this is your spine.
Both found.
Both muscles found the muscles there.
Right?
Right.
It feels amazing.
So if you have someone who can do it for
you and you do the hyper volt and you
have on both sides, the muscles that line
your spine, it's gonna feel delicious.
Wow.
Wow.
Yeah.
That's good to know.
Yeah.
Excellent.
Yeah.
Good.
My favorite saying of all time, for most
people when they're injured, most people
think I'm just gonna sit and do nothing.
That's not the case.
Unless you have a broken bone
that good, you need to rest that
of course, put it in a cast.
Um, but if you have an injury, my favorite
saying of all time is motion is lotion.
So I like it.
Yeah, that's a good one right there.
I know.
I said it's true.
All of my patients, I see it True.
Which means what?
You gotta do the motion,
you gotta keep moving.
You gotta keep moving.
You gotta keep moving.
So say you have, say you have a
lumbar disc herniation, a sciatica.
If you sit all day, your
sciatica is gonna be much worse.
You need to keep moving because
movement brings blood to the area.
You want constant re refresh of new
blood to help heal any injured tissues.
Same thing.
Tennis elbow, maybe you can't play
tennis or you can't play any paddle.
You should still be moving, you should
still be using your arms just in a way
that's not gonna irritate it because
it's gonna help bring fresh blood to
the area and help heal you faster.
Thank you for joining us.
Thank you so much for having me.
I really appreciate it.
We had a great time and, and me too.
And thank you for helping us
and to do all this and all that.
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