hol+ with Dr. Taz MD | The Future of Medicine is Holistic | The No. 1 Contributor to Chronic Pain & Why it's NOT Just a Result of Aging with Dr. Dan Ginader

What if your chronic pain, stiffness, or recurring injuries are not just about aging, but signals from a nervous system that feels overwhelmed, inflamed, and under-supported? In this episode, Dr. Taz sits down with physical therapist Dr. Dan Ginader, author of The Pain-Free Body, to unpack how modern lifestyles, stress, and sedentary habits are quietly driving the rise of chronic pain.

If you’re dealing with ongoing pain, fatigue, or inflammation and want deeper, root-cause support, join the Circle here:
👉 https://holplus.co/circle

Chronic pain is rarely just about one injury or one body part. It often reflects a deeper imbalance involving movement, mindset, inflammation, and how the brain interprets safety and threat.

Learn more about support related to this conversation:
Inflammation https://holplus.co/conditions/inflammation/
Arthritis / Chronic Joint Pain: https://holplus.co/conditions/arthritis-chronic-joint-pain/

In this episode, Dr. Dan explains why pain is not always a reliable indicator of damage, why MRIs and scans often don’t tell the full story, and how fear, stress, and inactivity can keep pain stuck in the body. He breaks down what actually drives chronic pain, why so many people feel worse as they get older, and what simple daily habits can either worsen or reverse the process.

You’ll learn why movement is essential medicine, how optimism and mindset influence recovery, and why small, consistent actions matter more than occasional intense workouts. This conversation challenges the idea that pain is inevitable with age and offers a more hopeful, practical path forward.

If you’ve been told your pain is “just part of getting older,” or feel like nothing has fully worked, this episode will help you understand what might actually be missing.

In this video, we cover:

Why chronic pain is not just about aging
The real impact of sedentary lifestyles on the body
Why scans and imaging don’t always match your pain
How fear, stress, and mindset influence recovery
The difference between acute pain and chronic pain
Why “weekend workouts” can increase injury risk
Simple daily movement habits that reduce pain over time
How to catch early warning signs before pain becomes chronic

This is not just about fixing pain. It’s about understanding your body, rebuilding resilience, and creating a lifestyle that supports long-term strength, mobility, and ease.

About The Guest:
Dr. Dan Ginader, DPT is a Doctor of Physical Therapy, author of The Pain-Free Body, and Clinic Director at Mims Method Physical Therapy in New York City. He specializes in helping patients understand the root causes of pain and build long-term resilience through movement and education.

About Dr. Taz:
Dr. Tasneem Bhatia (Dr. Taz) is a triple board-certified integrative medicine physician,
bestselling author, and founder of hol+ a multi-location integrative medicine practice.
Learn more: https://doctortaz.com/about

Stay Connected:

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Subscribe to the video podcast: https://www.youtube.com/@DrTazMD/podcasts

Get your copy of The Hormone Shift: Balance Your Body and Thrive Through Midlife and Menopause

Follow Dr. Dan Ginader
https://www.instagram.com/dr.dan_dpt/
https://www.tiktok.com/@dr.dan_dpt
Check out Dr. Dan's book The Pain-Free Body

Host & Production Team

Host: Dr. Taz; Produced by ClipGrowth.com (Producer: Pat Gostek)

Chapters
00:00 Optimism and the surprising link to chronic pain

01:05 The #1 contributor to chronic pain: sedentary behavior

03:42 What most people get wrong about pain

04:46 Where pain actually comes from

07:51 How fear, stress, and expectation amplify pain

12:35 When acute pain becomes chronic pain

18:15 How much movement you actually need

20:55 Easy movement snacks to reduce pain

26:20 Why MRIs and scans often don’t explain your pain

50:45 The #1 rule for staying pain-free as you age

Creators and Guests

Host

Dr. Taz Bhatia MD

Dr. Taz Bhatia is a triple-board-certified integrative medicine physician and founder of hol+, where she brings together science, spirit and the human experience to deliver holistic, whole-person care.

Producer

Pat Gostek

Founder of ClipGrowth.com - End-to-End YouTube, Podcast & Clips Management (you just record).

What is hol+ with Dr. Taz MD | The Future of Medicine is Holistic?

hol+ with Dr. Taz MD is redefining modern medicine through a comprehensive, evidence-based holistic approach; integrating functional medicine, integrative medicine, and time-tested healing systems to treat the whole human, not just symptoms.

Hosted by Dr. Tasneem Bhatia (Dr. Taz), triple board-certified physician in integrative, functional, and holistic medicine, bestselling Penguin Random House author, and founder of hol+; a comprehensive evidence-based holistic medicine platform with clinics in Atlanta, New York City, and Los Angeles, and virtual care available nationwide.

At the heart of hol+ is a revolutionary framework: the Five Body Map- physical, mental, emotional, energetic, and social/community bodies that create whole health. This whole-human approach connects hormone imbalances, gut dysfunction, microinflammation, cortisol dysregulation, metabolic disease, autoimmune conditions, perimenopause, and stress-driven illness to the full spectrum of who we are; body, mind, and spirit.

Each episode explores Dr. Taz’s original clinical frameworks ;The Cortisol Loop, Microinflammation, and The Invisible Load alongside conversations with leading experts, celebrities, and thought leaders including Sophie Grégoire Trudeau, Katherine Schwarzenegger, Cameron Mathison, Carol Alt, Jane Seymour, Tamsen Fadal, and Kris Carr.

Topics include hormone health, gut health, GLP-1 and metabolic therapy, thyroid dysfunction, weight loss, inflammation, autoimmune disease, mental and emotional wellness, energetic health, and the future of holistic medicine.

This is the show where science and spirit converge- driving health, happiness, relationships, and family ecosystems.

Want to go deeper? Join Dr. Taz’s private community, the hol+ Circle ; medicine beyond the exam room. (holplus.co/circle)

A 2025 Webby Award honoree, recognized alongside the Mel Robbins Podcast in the 29th Annual Webby Awards, hol+ is built on the foundation of Super Woman Wellness, which surpassed 1 million downloads over 8 years.

This is medicine beyond the exam room. Welcome to hol+

[00:00:00] Dr. Dan Ginader, DPT: One of the things that can reduce pain at a chronic level the most reliably [00:00:05] is just optimism. Uh, when I tell people that [00:00:10] optimism can really make a radical difference in their pain, I generally gets a chuckle or it [00:00:15] gets a lack. Right? Yeah. 'cause it sounds kind of,
[00:00:16] Dr. Taz: I was like, come on,
[00:00:17] Dr. Dan Ginader, DPT: it, it sounds kind of silly.
[00:00:19] Dr. Dan Ginader, DPT: But [00:00:20] they have looked at the mindset in people dealing with chronic pain and the people with a more [00:00:25] positive mindset. Even if all the other factors, all the other cobi comorbidities are [00:00:30] equal, the people with a positive mindset will have fewer reports of pain, and that [00:00:35] pain when it does come on will be less intense.
[00:00:37] Dr. Taz: How many of us have woken up on a given morning [00:00:40] with a few aches and pains and have quickly said, oh my gosh, I'm [00:00:45] finally getting old. Well, we wanna change that dialogue and that narrative, and that's why [00:00:50] we invited our next guest onto the show. Dr. Dan is a Doctor of Physical [00:00:55] Therapy, author of the Pain-Free Body and Clinic Director at Mims [00:01:00] Method Physical Therapy in Midtown Manhattan.
[00:01:02] Dr. Dan Ginader, DPT: A 90-year-old person
[00:01:04] Dr. Taz: yeah, [00:01:05]
[00:01:05] Dr. Dan Ginader, DPT: that looks, that has good posture and they look strong. I guarantee you, they're [00:01:10] not sitting for longer than 30 to 45 minutes. Number one contributor to chronic pain is [00:01:15] sedentary behavior.
[00:01:16] Dr. Taz: Really? Yes. Okay. We've gotta hold that for a second. Okay. The number one [00:01:20] contributor to chronic pain is being sedentary.
[00:01:23] Dr. Taz: Yes. Or sedentary [00:01:25] behavior. Why?
[00:01:25] Dr. Dan Ginader, DPT: Well, it leads to a lot of tightness. It leads to a lot of atrophy. It leads to a [00:01:30] lot of weakness. People that are more sedentary are more likely to suffer from depression. People that suffer from [00:01:35] depression are more likely to suffer from chronic pain. The act of moving very little.[00:01:40]
[00:01:40] Dr. Dan Ginader, DPT: Has a lot to do in terms of contributing to the overall [00:01:45] complex of feeling pain, and so sedentary behavior is a really good way [00:01:50] to just describe a lot of different factors when it comes to things that can contribute to to chronic pain.
[00:01:54] Dr. Taz: [00:01:55] He specializes in sports, physical therapy, working with professional dancers [00:02:00] and Broadway performers, and treats with a full body approach rooted in [00:02:05] education and long-term resilience.
[00:02:07] Dr. Taz: Dr. Dan is passionate about helping people [00:02:10] understand why pain develops, why many aches are preventable, and what it takes to [00:02:15] stay active and independent as we age. Please join me in welcoming Dr. [00:02:20] Dan to the show. This episode is sponsored by Whole Plus, a holistic health platform [00:02:25] built around education.
[00:02:26] Dr. Taz: Personalization and integrative care. Whole plus [00:02:30] blends holistic, integrative and functional medicine clinics with learning [00:02:35] resources like blogs, YouTube videos, and of course this podcast. So you're not just treated, [00:02:40] you're informed. The platform also includes holistic health quizzes and a curated wellness [00:02:45] shop, helping you make choices that support your body at the root level.
[00:02:49] Dr. Taz: Whole [00:02:50] Plus is holistic healthcare designed for real
[00:02:53] Dr. Dan Ginader, DPT: life. Visit [00:02:55] us@wholeplus.co to learn more about the platform. Again, that's HOL [00:03:00] ps.co.
[00:03:01] Dr. Taz: All right. I opened the intro talking about the [00:03:05] fact that so many people I meet and I, and I'm sure the audience would resonate with this, [00:03:10] you know, we'll wake up with an ache or a pain somewhere, and their first go-to response is like, [00:03:15] oh my God, I'm getting old, or.
[00:03:17] Dr. Taz: You have the weekend warrior and they're out there doing [00:03:20] pickleball or training for that marathon, and boom, they rupture something, damage [00:03:25] something. I actually did that myself. I ruptured my Achilles a couple years ago. Oh no. So anyhow, [00:03:30] all of these ideas that we have around pain and the body, you know, [00:03:35] are things that you have dug deeply into and explore over and over again.
[00:03:39] Dr. Taz: What do we get [00:03:40] wrong when we're talking about pain?
[00:03:42] Dr. Dan Ginader, DPT: I think the main thing that people get wrong is that pain is [00:03:45] unavoidable when in reality, almost all the causes of pain, especially the cause that [00:03:50] you listed, is just somebody doing a little too much too soon. Sometimes it's somebody that thinks that [00:03:55] they can handle pickleball, but they lose track of the fact that they haven't made a quick cutting movement in about a decade.
[00:03:59] Dr. Taz: Mm.
[00:03:59] Dr. Dan Ginader, DPT: [00:04:00] Sometimes it's people that think that, oh, all I did was go to the grocery store and then go to Home Depot [00:04:05] and then go somewhere else. But they lose track of the fact that they've been more or less sitting down for the [00:04:10] past two weeks and they haven't run three consecutive errands back to back to back.
[00:04:13] Dr. Taz: Mm.
[00:04:13] Dr. Dan Ginader, DPT: And so it's all [00:04:15] relative to the scale of what you're used to. And then if you do a little too much, a little too soon, that's generally [00:04:20] where a lot of this pain can come from.
[00:04:21] Dr. Taz: Interesting. What do we get wrong when we. [00:04:25] Think about pain. Is there something that we're just not understanding when it comes to the physiology and the [00:04:30] root cause of pain?
[00:04:30] Dr. Taz: I think, you know, aging, everyone will blame aging. Like I mentioned, some [00:04:35] people will think that they did something physically wrong in their day-to-day activity or in a [00:04:40] sport, you know, is that the true root cause of pain? Like where is pain [00:04:45] actually coming from?
[00:04:46] Dr. Dan Ginader, DPT: Well, the funny thing about pain is that there isn't ever one true cause, [00:04:50] especially when pain is chronic, meaning that pain has been around for longer than three months.
[00:04:54] Dr. Dan Ginader, DPT: A lot of that [00:04:55] cause is coming from the brain or coming from your nervous system or coming from the [00:05:00] expectation of pain or your relationship with pain, and the longer pain is around the less. Of a [00:05:05] relationship, it has to actual an actual mechanical cause. Mm. So obviously if you make a quick movement, you rupture [00:05:10] your Achilles.
[00:05:10] Dr. Dan Ginader, DPT: That is a one-to-one correlation. That's a mechanical cause. That's where your pain is coming from. [00:05:15] But when it comes to a back pain that is. Very prominent in today's culture in [00:05:20] today's world and millions and millions of people are dealing with it. Yeah, yeah. I've been dealing with it. I think a lot [00:05:25] of what people tend to get wrong is they lose track of just how complex that pain can [00:05:30] be and they want to blame it on age, or they wanna blame it on arthritis, or they wanna blame it on one [00:05:35] specific thing, especially something that's out of their control.
[00:05:37] Dr. Taz: Mm-hmm.
[00:05:37] Dr. Dan Ginader, DPT: When in reality, pain is far more complex than [00:05:40] that and there's a lot more in your, your control than, than isn't.
[00:05:43] Dr. Taz: So what is the root [00:05:45] cause of pain? Then? What, where, where is if we had to dial it down, right. When I sit with patients, I'm always like, okay, [00:05:50] this is our starting point. This is, this is like ground zero, you know, of everything we're dealing with.
[00:05:54] Dr. Taz: [00:05:55] You know, what is the, where's ground zero when we're talking about pain?
[00:05:59] Dr. Dan Ginader, DPT: Ground [00:06:00] zero would be, I guess if you really had to pinpoint it, would just be how your brain [00:06:05] is interpreting the threat that it's getting somewhere in the body. And so that [00:06:10] is why people can have radically different pain tolerances to the same exact stimulus.
[00:06:14] Dr. Dan Ginader, DPT: It's because their [00:06:15] brains are interpreting that threat as either something more threatening that deserves more of a pain [00:06:20] response or less threatening that deserves less of a threat. Uh uh. Pain response. So if you look at a [00:06:25] chef that is used to touching hot things, dealing with hot things, I've seen a chef reach in and [00:06:30] flip a chicken cutlet and
[00:06:31] Dr. Taz: Oh, really?
[00:06:31] Dr. Dan Ginader, DPT: Rip and ripping hot oil with their fingers? Ah, uh, sure. [00:06:35] Part of that is that they've done that enough to where they've built up calluses and sure they, they have a little bit [00:06:40] more of a resilience in their fingertips, but also their brain has learned over time by [00:06:45] doing that, that while their finger may feel a little hot, and while it may hurt in the short term, [00:06:50] they've kind of.
[00:06:51] Dr. Dan Ginader, DPT: Figured out that it is not an overly threatening thing that deserves [00:06:55] a large pain response. Whereas if you take someone who has never done that before, their brain [00:07:00] is like, that's the hottest thing I've ever touched in my life. This must be harmful. We deserve a, [00:07:05] a high pain response so that we know to retract our hand, take it away.
[00:07:09] Dr. Dan Ginader, DPT: And so we don't [00:07:10] do that again. And so the relationship with pain. Is far, has [00:07:15] far more to do with how much pain you feel than at the actual mechanical stimulus.
[00:07:19] Dr. Taz: [00:07:20] So we had studied forever ago, and I'm blanking, uh, there was like a [00:07:25] pain pathway or pain cycle, right? That sort of, you know, perpetuated [00:07:30] itself.
[00:07:30] Dr. Taz: Is that. Kind of what you're talking about, like once we experience pain, [00:07:35] then the anticipation of that pain or the fear of that pain sort of potentiates, it makes it [00:07:40] more and more and more intense each cycle around. Is that a part of this pain [00:07:45] equation? Is a lot of our emotional response to it, not just the actual [00:07:50] physical response to it.
[00:07:51] Dr. Dan Ginader, DPT: 100%. Because let's say you are in pain, that pain may limit [00:07:55] your sleep. If you limit your sleep, you also kind of raise your cortisol levels. You're, you're less [00:08:00] adept to, to deal with that pain. The more you feel pain, the more you expect to feel that pain. Uh, a lot [00:08:05] of studies have been done that show just you expecting to feel pain will increase [00:08:10] your pain response.
[00:08:11] Dr. Dan Ginader, DPT: And so it starts to feed into this never ending loop. [00:08:15] And that's also why, uh, one of the things that can reduce pain at a chronic level the [00:08:20] most reliably is just optimism. Uh, when I tell people [00:08:25] that optimism can really make a radical difference in their pain, it [00:08:30] generally gets a chuckle or it gets a left right?
[00:08:31] Dr. Taz: Yeah. Does it sounds, everyone's like, come on,
[00:08:33] Dr. Dan Ginader, DPT: it sounds kind of silly, [00:08:35] but. They have looked at the mindset in people dealing with chronic pain [00:08:40] and the people with a more positive mindset. Even if all the other factors, all the other cobi comorbidities [00:08:45] are equal, the people with a positive mindset will have fewer [00:08:50] reports of pain.
[00:08:50] Dr. Dan Ginader, DPT: And that pain when it does come on will be less intense.
[00:08:53] Dr. Taz: I mean, that's groundbreaking in [00:08:55] itself, right? So if we are saying optimism. Can change pain and a [00:09:00] positive mindset really does shift your perception of pain. [00:09:05] When patients come into the exam room or into your office and complaining of [00:09:10] pain, where do you start with them?
[00:09:12] Dr. Taz: Do we start with the mind and emotions or We do we start [00:09:15] where the injury actually may or may not be.
[00:09:18] Dr. Dan Ginader, DPT: So the place that I have [00:09:20] to start. I have to show that I'm listening to them and I have to show that I [00:09:25] understand where they are in terms of their pain. And then I try to [00:09:30] explain how that pain may have manifested, how, how that pain may have grown.
[00:09:34] Dr. Dan Ginader, DPT: And then [00:09:35] I try to find one thing, even if it's small, to change the pain, because even if [00:09:40] I can only change that pain a little bit. Or even if I can only change that pain for the next hour that they leave, [00:09:45] at least I then give them the thought and I give them the hope that, oh, something can be [00:09:50] done about this.
[00:09:50] Dr. Dan Ginader, DPT: It's not hopeless. Um, and then once I kind of. [00:09:55] Feed them that idea, then they're more likely to do the exercises, the [00:10:00] mobilizations, to kind of move forward. The work that
[00:10:02] Dr. Taz: go.
[00:10:03] Dr. Dan Ginader, DPT: Exactly.
[00:10:04] Dr. Taz: So interesting, [00:10:05] I see this in practice as well, is that that message of, you know, hope, [00:10:10] right? Or like this will go away, or this can get better, you know, this is not a life sentence [00:10:15] in itself.
[00:10:16] Dr. Taz: Is such a healing statement for so many people, and I think people don't [00:10:20] hear that enough from their practitioners and their teams and their providers, you know? Why do [00:10:25] you think we don't lead with that when we're managing, you know, patients [00:10:30] or issues with pain or injuries or any of these different things?
[00:10:34] Dr. Dan Ginader, DPT: Well, [00:10:35] unfortunately, if it's not done correctly, I think it can come off as condescending.
[00:10:38] Dr. Taz: Mm.
[00:10:39] Dr. Dan Ginader, DPT: Because especially [00:10:40] somebody like myself that
[00:10:41] Dr. Taz: I can see that
[00:10:41] Dr. Dan Ginader, DPT: our physical therapy clinic is more expensive and [00:10:45] it's a little harder to get in. We generally have like a six week wait list. Mm-hmm. And so for the most part, we are seeing people that [00:10:50] have seen a bunch of other medical practitioners, and the thing that they're not happy with is they feel like they [00:10:55] haven't been listened to.
[00:10:56] Dr. Dan Ginader, DPT: They feel like they're not taken, taken seriously, and they just feel kind of [00:11:00] scorn by the process of. Dealing with American healthcare.
[00:11:03] Dr. Taz: Yeah.
[00:11:03] Dr. Dan Ginader, DPT: And so [00:11:05] I always try to make sure that, that first session I really listen. I [00:11:10] really let them know that I'm here for them and I understand where they're coming from, but if I try [00:11:15] to jump to, oh, you'll be fine.
[00:11:17] Dr. Taz: Right? Or,
[00:11:17] Dr. Dan Ginader, DPT: oh yeah, this will get better.
[00:11:19] Dr. Taz: Yeah. Or this is [00:11:20] normal.
[00:11:20] Dr. Dan Ginader, DPT: Right?
[00:11:20] Dr. Taz: That's another one.
[00:11:21] Dr. Dan Ginader, DPT: Right. Then I'm, I'm almost discrediting their experience in a way, [00:11:25] and so. It does you, I think you really do have to build a relationship [00:11:30] first, and you do have to show that you have the tools to make that, that little change, [00:11:35] to then build in that, that trust and then, and then we can have the [00:11:40] more kind of complex talks about.
[00:11:41] Dr. Dan Ginader, DPT: The, the nature of pain
[00:11:44] Dr. Taz: and when does [00:11:45] pain go from, okay, I hurt myself, I told you about my Achilles. When does it go from something [00:11:50] acute to then chronic pain? Like when does that trans, when and how does [00:11:55] that transition happen? Like I, again, going back to me, it's not all about me, but I ruptured my [00:12:00] Achilles, right?
[00:12:00] Dr. Taz: 2021. Horrible, you know, couldn't move. [00:12:05] Limited mobility. But I came back. Right. And I'm back to doing everything I [00:12:10] used to do. I don't run 'cause I'm, I'm scared honestly. But, but, uh, but I, I do just [00:12:15] about everything else. So I, I'm past it now. That acute pain [00:12:20] episode is not a chronic pain issue for me. Why do some people move [00:12:25] from an acute pain issue to more of a chronic pain type [00:12:30] syndrome?
[00:12:30] Dr. Taz: And I see that a lot in the exam room. What do you think is happening there?
[00:12:34] Dr. Dan Ginader, DPT: Well, I think [00:12:35] you mentioned it just a little bit in the rundown of that question. So the, by the book definition of a chronic pain is a pain that's [00:12:40] been around for longer than three months. So chronic pain kind of has this almost dirty [00:12:45] connotation to it.
[00:12:45] Dr. Dan Ginader, DPT: But if you've been feeling a discomfort for longer than three months, we can call that chronic pain. And the [00:12:50] thing that contributes most to chronic pain in terms of what I've seen as a practicing physical therapist [00:12:55] is in the same way that you said that you were. Afraid to return to running.
[00:12:58] Dr. Taz: Right, right.
[00:12:58] Dr. Dan Ginader, DPT: Uh, running is a higher [00:13:00] level activity, of course, right? Like you're still capable and you're still able to do a bunch of things. But that same [00:13:05] process takes place for a lot of other people where the thing that they're returning to or afraid of [00:13:10] returning to may not be something as high level as running.
[00:13:12] Dr. Dan Ginader, DPT: It may be as simple as leaving the house. It may be as [00:13:15] simple as walking around the block. Mm. And the number one contributor to chronic pain is [00:13:20] sedentary behavior.
[00:13:21] Dr. Taz: Really? Yes. Okay. We've gotta hold that for a second. Okay. The number one [00:13:25] contributor to chronic pain is being sedentary. Yes. Or sedentary behavior.
[00:13:29] Dr. Taz: [00:13:30] Why?
[00:13:30] Dr. Dan Ginader, DPT: Well, it leads to a lot of tightness. It leads to a lot of atrophy. It leads to a lot of [00:13:35] weakness. People that are more sedentary are more likely to suffer from depression. People that suffer from [00:13:40] depression are more likely to suffer from chronic pain. The act of moving very little [00:13:45] has a lot to do in terms of contributing to the overall.
[00:13:49] Dr. Dan Ginader, DPT: [00:13:50] Complex of feeling pain. And so sedentary behavior is a really good way to [00:13:55] just describe a lot of different factors when it comes to things that can contribute to, to chronic pain.
[00:13:59] Dr. Taz: [00:14:00] So we used to talk about sedentary behavior only in older populations, right? Because, you know, maybe [00:14:05] they had retired or, you know, fallen into a certain pattern in their lifestyle, so they were [00:14:10] more sedentary.
[00:14:11] Dr. Taz: I actually think kids today are more se sedentary than they ever used to be. [00:14:15] Teenagers, you know, people in their twenties, everyone's like on a phone or a device or a computer, [00:14:20] you know? What does that look like in terms of the injuries that you guys are seeing on a [00:14:25] day-to-day basis? You know, are you just seeing seniors or are you.
[00:14:28] Dr. Taz: Seeing younger folks, are [00:14:30] you seeing, you know, this executive or sort of mid-career world where again, we're [00:14:35] just sitting at desk all, I mean, I'm right there with everyone just sitting at a desk, you know, kind of all day long and [00:14:40] then maybe thinking about movement as an afterthought or as a scheduled workout.
[00:14:44] Dr. Taz: I [00:14:45] mean, kind of tell us what you're seeing happening kind of in real life in your clinics.
[00:14:49] Dr. Dan Ginader, DPT: Well, I [00:14:50] was, I was practicing pre COVID. Mm-hmm. I had practiced from 2017 to [00:14:55] 2020, and. Everything that I've seen post COVID is [00:15:00] people have just become more sedentary.
[00:15:03] Dr. Taz: Yeah.
[00:15:03] Dr. Dan Ginader, DPT: Uh, a lot of people have gotten [00:15:05] used to working from home.
[00:15:06] Dr. Dan Ginader, DPT: A lot of people have gotten used to, maybe they were really active [00:15:10] before COVID hit, and then once COVID hit because the gyms were closed or because they didn't wanna leave or because they didn't wanna [00:15:15] out, maybe they haven't ever returned to that level of exercise. Right. [00:15:20] Um, and also, like you said, a lot of the, the younger kids, they're.
[00:15:23] Dr. Dan Ginader, DPT: They're not quite [00:15:25] as strong and agile as I feel like they were pre COVID.
[00:15:29] Dr. Taz: Mm-hmm.
[00:15:29] Dr. Dan Ginader, DPT: [00:15:30] Because of the, the culture of the iPads and the video games and things like that. And I don't think I can [00:15:35] necessarily blame them. I mean, video games are, it's the culture. Yeah. It's the culture and video games have gotten so good that [00:15:40] a.
[00:15:40] Dr. Dan Ginader, DPT: Everything is available to you just with your, with your thumbs, right? And then also you, you [00:15:45] kind of don't even have the excuse of, you need to go see friends, you need to go talk to friends. They're like, well, I'm talking to my
[00:15:49] Dr. Taz: friends. I am, they're [00:15:50] right here.
[00:15:50] Dr. Dan Ginader, DPT: I'm talking to my friends. They're right here, right?
[00:15:52] Dr. Dan Ginader, DPT: And my imaginary is running. My imagination's running wild. And so. [00:15:55] I think it's, it's both technology's gotten so good that we're sitting more, and I think [00:16:00] there was a massive shift in COVID that led to people being far less active than they were pre [00:16:05] COVID.
[00:16:05] Dr. Taz: That's so concerning to me. I mean, even my own son, you know, who's highly [00:16:10] intelligent and, and works really hard.
[00:16:12] Dr. Taz: I'm like having to remind him like, okay, [00:16:15] have we gotten any physical activity today? Have we moved at all today? Because he's in a season [00:16:20] right now where he doesn't have a sport. And it, it's like that dynamic activity that happens beyond [00:16:25] maybe walking the campus is negligible, you know? And so I'm just going like, this can't, this [00:16:30] can't be good.
[00:16:30] Dr. Taz: And what does it mean for these kids in this generation in another [00:16:35] 20 years or in another 30 years? Are there common injuries that you're seeing over and over [00:16:40] again?
[00:16:40] Dr. Dan Ginader, DPT: I think it's less about the commonality of a certain diagnosis [00:16:45] and more just I'm seeing younger people than I was ever used to.
[00:16:48] Dr. Taz: Interesting.
[00:16:49] Dr. Dan Ginader, DPT: When [00:16:50] I first started working, it was uncommon for me to see someone who was younger than [00:16:55] 30. It was, it was downright strange. It was nice because for the most part, it meant that they [00:17:00] were an athlete. Mm-hmm. Or it meant that they were so active that it was mostly an overuse thing.
[00:17:04] Dr. Taz: Yeah.
[00:17:04] Dr. Dan Ginader, DPT: [00:17:05] But now I'm seeing a lot more people.
[00:17:08] Dr. Dan Ginader, DPT: In their twenties and in their young thirties [00:17:10] that are dealing with a kind of pain that I more so would've associated with just a, [00:17:15] a mid forties, early fifties corporate worker. And it's, [00:17:20] it's really, it's really kind of interesting and a little scary, just how, [00:17:25] how much activity has kind of turned down in, in today's culture.
[00:17:29] Dr. Taz: [00:17:30] So if we're trying to write, you know. Pain prevention prescriptions [00:17:35] and we're doing it by age group, you know, what would you tell, you know, [00:17:40] a teenager or somebody in their early twenties, like how much should they be moving to [00:17:45] prevent chronic pain? What would you tell somebody in that midlife era? Maybe [00:17:50] 35 ish to 50.
[00:17:51] Dr. Taz: And what would you tell someone kind of over 55 or so, [00:17:55] like is there, you know, if we could help. People quantify it a little bit because I think people get into [00:18:00] habits. It's just like diets, right? You get into habits and you don't realize what you're doing until someone kind of [00:18:05] shows you. So if we could help people maybe quantify like, this is the [00:18:10] minimum amount of activity that you should be doing, what would you tell them?
[00:18:14] Dr. Dan Ginader, DPT: [00:18:15] I would normally start with the American Heart Association has a general [00:18:20] recommendation in terms of how much activity you need to reduce your risk of all cause mortality. And it's [00:18:25] 150 minutes a week of moderate exercise. And so you just split that up [00:18:30] between 30 minute workouts five days a week. And if you're doing that, that's a really good start.
[00:18:34] Dr. Dan Ginader, DPT: Okay. And then [00:18:35] regardless of age, in those 30 minutes of activity, I encourage people to try as [00:18:40] many different things as possible. If you think that you would enjoy yoga. Try yoga. If you think that you might enjoy [00:18:45] Pilates, try Pilates. If the only thing that you wanna do is walk around the block, walk around the block, but [00:18:50] try enough things to figure out what you really connect with.
[00:18:52] Dr. Dan Ginader, DPT: And the thing that you connect with may surprise you. [00:18:55] Maybe you're, maybe you take a dance class and you're like, oh, maybe I, I should be dancing more. But [00:19:00] the thing that you enjoy is the thing that you're going to end up doing. [00:19:05] Nobody is going to sustain a workout or an exercise routine if it is [00:19:10] filled with stuff that they don't enjoy.
[00:19:12] Dr. Dan Ginader, DPT: And. I've yet to find [00:19:15] someone who can't find something that involves moving their body, that they don't at least [00:19:20] enjoy a little bit. And then the thing that you enjoy is the thing that I will hammer that you do, because [00:19:25] that's the most likely thing that, that you will continue to do.
[00:19:27] Dr. Taz: It doesn't feel like 30 minutes a day, five [00:19:30] days a week is a tall order.
[00:19:31] Dr. Taz: Are people not even moving that much?
[00:19:33] Dr. Dan Ginader, DPT: So a lot of [00:19:35] people, especially now with the rise of exercise classes,
[00:19:38] Dr. Taz: right?
[00:19:39] Dr. Dan Ginader, DPT: They think if I [00:19:40] can get to two exercise classes a week. I'm fine.
[00:19:43] Dr. Taz: Ah,
[00:19:43] Dr. Dan Ginader, DPT: and then I see they're [00:19:45] working out for two hours a week, and it's split up between, you know, a Monday and a Thursday, [00:19:50] and then outside of that Monday and Thursday for one hour a pop, you're, you're sitting all [00:19:55] day working at a computer, and then you put the computer away and you sit on the couch and then you watch tv and there's [00:20:00] very little movement in the interim.
[00:20:02] Dr. Dan Ginader, DPT: Mm. And it's that lack of interim [00:20:05] movement. That seems to be the issue, not just because there's so much [00:20:10] sedentary behavior in between, but also if the two main things that you're [00:20:15] doing are sitting. And then doing a really tough workout,
[00:20:18] Dr. Taz: right?
[00:20:19] Dr. Dan Ginader, DPT: That's a big [00:20:20] difference between your two states of motion. And that difference introduces a [00:20:25] lot of risk for injury.
[00:20:26] Dr. Taz: Interesting. So, so many people do think that way. They're like, and that's [00:20:30] probably the weekend warrior, right? Yes. Like, I'm gonna power it through these workouts, but I'm gonna like sit the rest of the time [00:20:35] and do everything else. Are there some basic hacks that you tell those type of [00:20:40] people to kind of put into their lives to help get like sneaky movement or [00:20:45] movement snacks, I think some of us call it so that there is more movement throughout any [00:20:50] given day so they're not susceptible to a pain, you know, a pain episode or an injury.[00:20:55]
[00:20:55] Dr. Dan Ginader, DPT: I'll normally start with just asking them if they have a sit to stand desk. A lot of times, [00:21:00] especially here in New York City, if they work in office, a lot of times they have access to a sit to stand [00:21:05] desk, and if that is something you have access to, the general recommendation is you sit for 20 [00:21:10] to 30 minutes.
[00:21:10] Dr. Dan Ginader, DPT: Then stand for 20 to 30 minutes and it's that back to forth, that back and forth, that has a really [00:21:15] good success. Also, the interesting thing about why standing desks are better than sitting [00:21:20] desks is that while you are standing, it's not the act of standing that makes you less likely for pain [00:21:25] or, or.
[00:21:26] Dr. Dan Ginader, DPT: Anything like that, it's because standing is inherently [00:21:30] less comfortable than sitting without you noticing. You're shifting your weight back and forth. You're rising up on your [00:21:35] toes, you're shifting back on your heels. You're maybe doing some mm interesting, some little tiny mini squats, or because you're [00:21:40] already standing, you may like walk a little bit over here, walk a little bit over there.
[00:21:44] Dr. Dan Ginader, DPT: And so it's that [00:21:45] constant movement that takes place while standing. That is actually the thing that makes standing [00:21:50] better for you. And so if you only have access to sitting. I suggest every [00:21:55] 30 to 45 minutes just do 10 sit to stands. Or every time you go to the bathroom, just do like 10 [00:22:00] pushups against the wall or try to find a way to [00:22:05] move and a way to do something every time you stand up anyway, so you don't have to kind of.[00:22:10]
[00:22:10] Dr. Dan Ginader, DPT: Force it into your day or you don't have to feel like you're doing something you wouldn't have done anyway. But if you [00:22:15] already are getting up out of your chair, do some sit to stands, do some bridges, do some [00:22:20] just take three to five minutes and just move more and, and vary the movement and stuff [00:22:25] that small can start to really build up and make a difference.
[00:22:27] Dr. Taz: I mean, I know we're talking about pain today and, uh, you know. [00:22:30] Pain and the experience of pain and, and what to do around it or about it. [00:22:35] But it's interesting, even when we have conversations around metabolic health or blood sugar, you know, [00:22:40] being sedentary is a part of the problem. And one of the things that I was looking at recently, [00:22:45] there's a really interesting study saying, just doing like 10 minutes of squats or [00:22:50] lunges or step-ups right before a meal will drop your blood sugar, you [00:22:55] know, a significant amount so that you don't store fat.
[00:22:57] Dr. Taz: Post that meal. It keeps that, you know, [00:23:00] metabolic home going. And so it's interesting. It seems like, you know, should we be telling [00:23:05] people or should we be practicing like, Hey, for every hour you're sitting, you [00:23:10] know, walk for 10. Mm-hmm. You know? Does a strategy like that help when it comes to preventing [00:23:15] pain?
[00:23:15] Dr. Dan Ginader, DPT: I think it can for sure, because like you said, it helps to quantify things for people.
[00:23:18] Dr. Taz: Yeah.
[00:23:19] Dr. Dan Ginader, DPT: I think the important [00:23:20] thing to, to keep in mind, and it's something that I tell my patients, is all you need to do is keep this up for two [00:23:25] and a half, three weeks. If you can just be regimented for two and a half, three weeks, I [00:23:30] guarantee that your body and you will feel a difference.
[00:23:32] Dr. Dan Ginader, DPT: And then all you have to do is feel [00:23:35] that difference and then you're just gonna continue to do it all by yourself because it really is [00:23:40] obvious to you and the way you feel once you start doing it. And you [00:23:45] just need to. Get on the other end of that habit forming amount of time of that kind of like [00:23:50] two to three weeks.
[00:23:51] Dr. Taz: Three weeks seems to be the magic number, doesn't it? Yes. Like the 21 days get to like [00:23:55] roughly 21 days and, and something that's new will become a habit and [00:24:00] become something that you crave at some point, right? It doesn't feel that hard anymore as we age. [00:24:05] It seems like we become more susceptible to pain.
[00:24:07] Dr. Taz: Now, we have talked about how it's an issue now for [00:24:10] children and teens and young adults because everybody's sitting more, being sedentary is the number [00:24:15] one, you know, to use your words cause of chronic pain or cause of pain, you know? But [00:24:20] why does it seem like as we age we're even more susceptible? What's changing chemically or [00:24:25] physiologically?
[00:24:25] Dr. Taz: What's going on there?
[00:24:26] Dr. Dan Ginader, DPT: So I would say for the most part, it's just that as we get older and as we [00:24:30] age, we do just become. Less mobile. We don't move around as much as we get busy. A lot of our [00:24:35] busyness involves being on a computer, being on a phone, uh, and so we just move less. [00:24:40] You brought up metabolism a little earlier.
[00:24:41] Dr. Taz: Yeah.
[00:24:41] Dr. Dan Ginader, DPT: I think an important thing to bring up is that for the most part, your [00:24:45] metabolism doesn't really shift. Until you're in your fifties.
[00:24:48] Dr. Taz: Mm-hmm.
[00:24:48] Dr. Dan Ginader, DPT: And then the thing [00:24:50] that does shift is oftentimes how active you are, but outside of just becoming less [00:24:55] active, the thing that does change is arthritis is a very natural cause or a very [00:25:00] natural thing that happens just as you age.
[00:25:02] Dr. Dan Ginader, DPT: Um. You do start to [00:25:05] lose height in between the discs of your vertebrae, you will start to to kind [00:25:10] of, you know, as your body slowly dehydrates over time, you will start to feel a little stiffer in the [00:25:15] ligaments. You will start to feel a little stiffer in the joints, but. The terminology that I use or [00:25:20] like to kind of steer people towards is that all this does is it reduces your margin for [00:25:25] error.
[00:25:25] Dr. Taz: Hmm.
[00:25:25] Dr. Dan Ginader, DPT: It's not a life sentence for pain. It's not something that you can blame for the [00:25:30] rest of your life just because you have a little bit of arthritis. It, all it does is that it reduces your margin [00:25:35] for error because it increases the amount of inflammation that's already present in those joints. [00:25:40] And so you have to work a little harder maybe to stay flexible or you have to work a little harder to.[00:25:45]
[00:25:45] Dr. Dan Ginader, DPT: Maintain that mobility, but you can still stay ahead of that arthritis. And [00:25:50] then the third thing that I kind of try to drive home is that. There's a [00:25:55] very, there's very little correlation between what is shown on an x-ray, what is shown [00:26:00] on an MRI, and then what is felt in terms of symptoms.
[00:26:03] Dr. Taz: Thank you. I think everyone [00:26:05] needs to, to hear that because many people come in so devastated or so [00:26:10] upset because an x-ray or an MRI are again, quote unquote, [00:26:15] normal, but they feel terrible and they want an explanation or want an answer.
[00:26:19] Dr. Taz: What's [00:26:20] happening there?
[00:26:20] Dr. Dan Ginader, DPT: So again, it goes back to how complex pain is and [00:26:25] especially when it comes to back pain where you have the discs and you have the nerves, and you have the facet [00:26:30] joints, and you have all the things that can go wrong in a back if you've lived 40, [00:26:35] 50, 60 years. If you go get an MRI, something's gonna.
[00:26:39] Dr. Dan Ginader, DPT: Be [00:26:40] off something's. Mm-hmm. There's gonna be something that's a little degraded. There's gonna be right, probably a couple herniations. There's [00:26:45] gonna be, there's gonna something that's gonna be seen. But they've done [00:26:50] massive studies where they have done MRIs of people's backs [00:26:55] and then they have asked them, how much pain do you feel?
[00:26:57] Dr. Dan Ginader, DPT: How much pain do you feel? And there are people that have [00:27:00] multiple levels of disc herniations, multiple levels of, of arthritis that report minimal to [00:27:05] no pain. And they have people that show perfectly healthy MRIs that have [00:27:10] really nasty levels of chronic pain.
[00:27:13] Dr. Taz: Mm.
[00:27:13] Dr. Dan Ginader, DPT: And they've run enough of these [00:27:15] studies that the overall point.
[00:27:18] Dr. Dan Ginader, DPT: Is that your [00:27:20] pain has very little to do with what is seen on an image. Mm. And so it's [00:27:25] important to kind of detach yourself from that and then just focus on how you are feeling. 'cause [00:27:30] chances are, there are a lot, there are a lot of things that can be done to kind of change the direction of your symptoms.[00:27:35]
[00:27:35] Dr. Taz: If you're listening to this and thinking, I know something is often my [00:27:40] body, but I don't know where to start. This is for you. That's why [00:27:45] I created the circle. The circle is my private community where I and my team focus on [00:27:50] understanding your body from hormones and stress to metabolic health and [00:27:55] longevity with real life guidance that you can actually use.
[00:27:58] Dr. Taz: This is about clarity [00:28:00] and consistency and support beyond the exam room and maybe [00:28:05] outside of all the different appointments and experts that you've been running around to. You can try [00:28:10] the circle with a one month trial using the promo code [00:28:15] podcast@wholeplus.co back slash circle. Again, that's whole
[00:28:18] Dr. Dan Ginader, DPT: plus HOL [00:28:20] ps.co/circle.
[00:28:22] Dr. Dan Ginader, DPT: Alright, let's jump back into the [00:28:25] episode.
[00:28:25] Dr. Taz: So when someone does have. Pain. If, if, if you can have standardization [00:28:30] across an image, right? Then what is, again, I'm just thinking about all the [00:28:35] doctors. You know, we give pain medicines, we write these prescriptions, are we [00:28:40] doing something wrong?
[00:28:42] Dr. Dan Ginader, DPT: I mean, the whole pain medication, [00:28:45] opioid crisis is Right.
[00:28:46] Dr. Dan Ginader, DPT: I think a whole,
[00:28:47] Dr. Taz: that's a whole thing.
[00:28:47] Dr. Dan Ginader, DPT: That's a whole thing. Yeah. That's a whole, yeah. That's a whole [00:28:50] different conversation. Right. But again, if,
[00:28:52] Dr. Taz: but I mean, okay. Not to skim over that conversation real [00:28:55] quickly. Mm-hmm. Because I think the opioid crisis is real, and not to throw my profession under the [00:29:00] bus, but part of it was the.
[00:29:01] Dr. Taz: Over-prescribing of these medications, right, to patients. For [00:29:05] example, when I delivered my first child, when I had my wisdom teeth out, I was [00:29:10] instantly given Percocets tunnel with codeine. I wasn't even sort of [00:29:15] coached in terms of like, okay. You don't need to take these, but these are just for an [00:29:20] extreme.
[00:29:20] Dr. Taz: It was, no, you need to take these like every six hours for the next 48 hours [00:29:25] or X, Y, and Z is gonna happen. And being somebody who's like, I'm not taking anything, you know, I [00:29:30] never took them, you know? Mm-hmm. I kind of like, I don't need these. I'm gonna just. See how it goes. [00:29:35] But you know, for people who are following the doctor's orders and taking [00:29:40] medications for pain, when pain is a complex process that maybe doesn't need to be [00:29:45] managed with pain medications, like how, what do we tell them?
[00:29:49] Dr. Taz: Do we tell them to [00:29:50] stop taking those medications? Do we tell doctors to stop prescribing them? Like, what's the [00:29:55] answer?
[00:29:55] Dr. Dan Ginader, DPT: I think there already has been a shift to, to doctors prescribing the pain medication [00:30:00] less. Yeah. And. I think it just became the easy thing to do because pain is [00:30:05] complex,
[00:30:05] Dr. Taz: right?
[00:30:05] Dr. Dan Ginader, DPT: Getting rid of the pain is complex, but when you prescribe someone an [00:30:10] opioid.
[00:30:11] Dr. Dan Ginader, DPT: It's a really easy way to mask it, and it's just, it's gone. Yeah. And it's, it's [00:30:15] done.
[00:30:15] Dr. Taz: Yeah.
[00:30:15] Dr. Dan Ginader, DPT: But the good thing is, is that, at least in my office and people that I've seen over the years, [00:30:20] they already want to get off of those. I mean, the, the idea of addiction and, and the people that [00:30:25] have an addictive personality and have, have fallen into the trap of those medication, that's a [00:30:30] story.
[00:30:30] Dr. Taz: Right? Right.
[00:30:30] Dr. Dan Ginader, DPT: But the people that don't have that addictive. Mentality or that [00:30:35] affliction, they want to get off the medication 'cause they feel sluggish and they fail out of it and they feel [00:30:40] bad and they, and they don't wanna rely on a pill. And so that shift, I think is [00:30:45] happening. And then it opens up the door for all the other things that people do have [00:30:50] access for, uh, in terms of reducing the pain without the use of medication.
[00:30:54] Dr. Dan Ginader, DPT: And one of the [00:30:55] things that I consider the, the top tier a plus. [00:31:00] Outcome is when somebody tells me that they no longer need to take medication to deal with their pain. [00:31:05] And when, when we get to that point of care, that is how I know that I really made a A
[00:31:09] Dr. Taz: big difference. A big difference. [00:31:10] Well, one of the things I'm curious about, should we be thinking about pain more [00:31:15] as a sign of inflammation and then that inflammation could be coming [00:31:20] from anywhere, right?
[00:31:20] Dr. Taz: It could be emotional, it could be physiologic, it could be. Stress or [00:31:25] cortisol related, whatever. But if we think about it from the perspective of inflammation, [00:31:30] does that change how you. Take care of the patient or how the patient sees themselves. [00:31:35]
[00:31:35] Dr. Dan Ginader, DPT: Yeah, so what you're talking about there is something known as the symptomatic threshold.
[00:31:39] Dr. Dan Ginader, DPT: [00:31:40] So the reason that people can have arthritis but not necessarily pain is because our body is meant to [00:31:45] deal with a certain amount of inflammation before the body starts to read this as, oh, this should be [00:31:50] painful because it's, it's reached interesting, it's reached this point. And so what happens with arthritis is like, [00:31:55] let's say if you have a perfectly healthy joint, your, your symptomatic [00:32:00] threshold is.
[00:32:01] Dr. Dan Ginader, DPT: Is here, but you are down here. If you have arthritis, you may come a [00:32:05] little bit up here, meaning that your margin for error just decreases a little bit. But I like the, [00:32:10] I like thinking of it in terms of that because people can wrap their head around that where [00:32:15] another thing, so going back to arthritis.
[00:32:17] Dr. Taz: Yeah, yeah, yeah.
[00:32:19] Dr. Dan Ginader, DPT: I'll [00:32:20] have somebody come in with back pain. They get an X-ray. They say, Ugh, I have [00:32:25] arthritis. And I say, well, when did you start feeling this back pain? The answer is, oh, two to three months ago, I [00:32:30] really started to feel it and I was like, well, I have. A spoiler alert, your arthritis didn't pop up two [00:32:35] to three months ago.
[00:32:36] Dr. Dan Ginader, DPT: Arthritis is a slow process that happens over the course of years, [00:32:40] so that arthritis was likely present in your back for 1, 2, 3, [00:32:45] maybe even longer in terms of years, but you only started to feel pain two to three months [00:32:50] ago. That means that we can't necessarily blame the arthritis for the pain that you're feeling.
[00:32:54] Dr. Dan Ginader, DPT: [00:32:55] You just did something recently to take that inflammation above the symptomatic threshold. But [00:33:00] because that only happened two to three months ago and because you were more or less pain-free for years before [00:33:05] that, there's nothing to say that we can't get that back below that point and get you back [00:33:10] to the point to where you can live more or less a pain-free life.
[00:33:12] Dr. Taz: So it's a very different approach [00:33:15] to pain. It's looking more at, okay, nothing [00:33:20] really changed other than a tipping point that probably hit you. [00:33:25] What are the common tipping points for people?
[00:33:28] Dr. Dan Ginader, DPT: I think,
[00:33:28] Dr. Taz: let me say that again. What are the [00:33:30] common tipping points for someone to go from, you know, a regular injury [00:33:35] or a joint that maybe has had issues for years and years to now [00:33:40] something that is causing pain?
[00:33:41] Dr. Taz: You know, and that could be an arthritic situation. It could be something like [00:33:45] plantar fasciitis, it could be something like the rotator cuff tendonitis that we [00:33:50] see a lot. How, what is what takes somebody from point A to point B?
[00:33:53] Dr. Dan Ginader, DPT: A lot of times it's just [00:33:55] ignoring the signs.
[00:33:55] Dr. Taz: Mm.
[00:33:56] Dr. Dan Ginader, DPT: Very rarely will somebody go [00:34:00] from zero to a hundred outside of a.
[00:34:03] Dr. Dan Ginader, DPT: A traumatic injury [00:34:05] without ignoring signs. I have a lot of people, let's say, let's use plantar fasciitis [00:34:10] as an example.
[00:34:10] Dr. Taz: Yeah, yeah.
[00:34:11] Dr. Dan Ginader, DPT: That they'll come to me. I've had this, I've had this foot pain for three months. [00:34:15] It's searing in the morning. It's, it's really bad. And then we start going back the months and months [00:34:20] before that and they'll say, yeah, I've always been a little weaker on my right side.
[00:34:23] Dr. Dan Ginader, DPT: And oh yeah, I did have [00:34:25] like. A knee injury maybe like a couple years ago or, and, and I did have, [00:34:30] I was feeling like a lot of tightness in my calves, um, for like a, a year before [00:34:35] this. And it's, it's those kind of like little things that all of a sudden then [00:34:40] build to the point to where the thing that popped in, the thing that just no longer is, is.[00:34:45]
[00:34:45] Dr. Dan Ginader, DPT: Being as forgiving is the area in pain. And, and in that case it's the plantar [00:34:50] fasciitis, but it was the, it was all of the ignored signs and symptoms that that got us [00:34:55] there.
[00:34:55] Dr. Taz: What are a couple of signs and signs that we ignore? As busy people?
[00:34:59] Dr. Dan Ginader, DPT: As busy people? [00:35:00] Yeah. We ignore the feeling of tightness.
[00:35:02] Dr. Dan Ginader, DPT: Tightness. Okay. Or, or we ignore. [00:35:05] There are a lot of people that feel pain in their back after every time they stand up after sitting down for 15 [00:35:10] minutes.
[00:35:10] Dr. Taz: Wow. Okay.
[00:35:11] Dr. Dan Ginader, DPT: Uh, but they kind of almost resign themselves as to, oh, that's [00:35:15] just how I feel. Or, oh, it's because of my age. Mm-hmm. Or if they know they have something like arthritis, like, oh, that's just my [00:35:20] arthritis.
[00:35:20] Dr. Dan Ginader, DPT: Um, but because they only feel it in fleeting moments. [00:35:25] They just either say it will get better or they resign to themselves that that's just how I [00:35:30] feel. And then they only come to a physical therapy office, or they only make a doctor's appointment when [00:35:35] it truly is limiting something that they need to do in their day to day.
[00:35:39] Dr. Dan Ginader, DPT: They can no longer [00:35:40] drive the distance they need to get to work, or they can no longer go up and down a set of stairs. Something has. [00:35:45] I officially gotten to a breaking point to where they can't live their day to day, [00:35:50] but in the meantime, they were ignoring a lot of things that they were just feeling here or there that they thought would [00:35:55] either get better or just thought that that was the meant, the way they meant to feel.
[00:35:57] Dr. Taz: So if you are noticing that you have some of these [00:36:00] signs, like, you know, you notice like your hip hurts a little bit or you have a knee that's out, [00:36:05] or your back is hurting, or your shoulders, you know, what do you do? Do you go straight to physical [00:36:10] therapy or do you need to do some sort of inventory of some sort?
[00:36:13] Dr. Taz: You even mentioned, I [00:36:15] was thinking that the body gets dehydrated over time and that's a reason, you know, [00:36:20] to experience more pain. Do you start hydrating more? Like what are the things that [00:36:25] may be like, okay, here's some things I can do right now?
[00:36:27] Dr. Dan Ginader, DPT: I think the general recommendation is if you've been [00:36:30] feeling anything for 10 days, about a week and a half, you should try.
[00:36:34] Dr. Dan Ginader, DPT: [00:36:35] Something. There are so many resources available to you, whether it's social media or whether it's blog [00:36:40] posts, or whether it's a book. There are so many things available to you that will give you ideas on things that [00:36:45] you can change and things that you can try. And then I think the important thing is to try those [00:36:50] things and do them consistently and give it another 10 days.
[00:36:54] Dr. Dan Ginader, DPT: And if [00:36:55] after those 10 days, if you haven't made a difference, then it's time to see a professional. [00:37:00]
[00:37:00] Dr. Taz: What are some of the most common injuries you see in busy people? Let's, and we can even break it down a little bit [00:37:05] 'cause I know you take care of a lot of performers and dancers. I'm curious what you see in them, but what [00:37:10] about the executives?
[00:37:11] Dr. Taz: What about the frequent flyers, you know, what about your, you know, [00:37:15] weekend warriors? What are some of the most common injuries that we see that lead to pain?
[00:37:19] Dr. Dan Ginader, DPT: I would say neck [00:37:20] pain and back pain are the two most common injuries I see in busy people. And it [00:37:25] almost always ties down. It ties back to. How they're sitting.
[00:37:29] Dr. Dan Ginader, DPT: Um, [00:37:30] if you are experiencing back pain, a lot of times it's because you are spending a very long [00:37:35] period of time with that lower back and a rounded position.
[00:37:37] Dr. Taz: Mm-hmm.
[00:37:38] Dr. Dan Ginader, DPT: And that rounded position can put [00:37:40] increased pressure through the disc. And then if you are never getting outside of that rounded position, [00:37:45] you're always kind of, again, you've reduced that margin for error.
[00:37:48] Dr. Dan Ginader, DPT: And it can only take a little thing to get [00:37:50] to the point to where that disc may herniate or that disc may, may become painful. And then in neck [00:37:55] pain, it's kind of a similar, similar story where. A lot of people will. [00:38:00] Lose track of where their head is in space. They'll spend a lot of time with their head tilted one way.
[00:38:04] Dr. Dan Ginader, DPT: Yep. They'll, [00:38:05] they'll kind of spend a lot of time, a lot of this. Yeah. Main stress response is like holding the shoulders [00:38:10] up.
[00:38:10] Dr. Taz: Yep.
[00:38:10] Dr. Dan Ginader, DPT: Um, and it's probably those two things that are the most common things that I see in just your [00:38:15] busy, everyday professional. So
[00:38:16] Dr. Taz: neck
[00:38:17] Dr. Dan Ginader, DPT: and neck and
back,
[00:38:18] Dr. Taz: neck and back. And the busy [00:38:20] professional.
[00:38:20] Dr. Taz: Mm-hmm. What about the frequent flyer?
[00:38:21] Dr. Dan Ginader, DPT: The frequent flyer is almost always back.
[00:38:24] Dr. Taz: Back,
[00:38:24] Dr. Dan Ginader, DPT: yeah. [00:38:25]
[00:38:25] Dr. Taz: Upper, lower,
[00:38:25] Dr. Dan Ginader, DPT: lower back.
[00:38:26] Dr. Taz: Okay.
[00:38:26] Dr. Dan Ginader, DPT: And as a, I'm six foot eight. Uh, [00:38:30] planes are kind of my, like the bane of my nemesis. Yeah.
[00:38:32] Dr. Taz: Yeah.
[00:38:33] Dr. Dan Ginader, DPT: Uh, they're not comfortable for me, but they, [00:38:35] they're also not comfortable for everybody.
[00:38:36] Dr. Taz: Right.
[00:38:37] Dr. Dan Ginader, DPT: Uh, and the thing that the plane seat kind of has in [00:38:40] common is that it's like, it's just like a flat plane seat. Right. And so there's, there's no way to get your [00:38:45] back in a way to where that, uh, that seat is providing any level of support. [00:38:50] And so your, your back is in this rounded position. It's in this. Not great [00:38:55] position for long periods of time.
[00:38:56] Dr. Dan Ginader, DPT: And then because you are in this plane and in this [00:39:00] seat for hours and hours at a time, chances are you're just not moving. And so it's the combination both [00:39:05] of, of how you're sitting over and over and over in an unsupportive chair, and then the [00:39:10] amount of time that you're sitting without moving. And both of those things have, they just can do some nasty, nasty [00:39:15] work to, to a lower back.
[00:39:16] Dr. Taz: So for the exec, for the busy person or the executive type [00:39:20] person, or the frequent flyer, and sometimes they're the same people, what are things you recommend for them to do [00:39:25]
[00:39:25] Dr. Dan Ginader, DPT: if you're currently dealing with a back pain? I always suggest either having a travel [00:39:30] pillow or having a, a. Uh, a sweatshirt that you can roll up and place behind your back
[00:39:34] Dr. Taz: on [00:39:35] your lower back?
[00:39:35] Dr. Dan Ginader, DPT: Yes.
[00:39:36] Dr. Taz: Okay, got it.
[00:39:36] Dr. Dan Ginader, DPT: Because if you know that your lower back pain is tied to you sitting and sitting with a [00:39:40] rounded back, the best thing you can do is get it into a position of slight extension. And the easiest way to do that [00:39:45] is to put something behind your back. And a lot of people that sit on the plane and put something behind their back for the [00:39:50] first time, but you can see the lights go off and they can be like.
[00:39:52] Dr. Dan Ginader, DPT: Oh, I was just spending too much [00:39:55] time in this one position. Now that I'm at back in this position, that feels much better. And then as, as [00:40:00] annoying as it may be, get up outta your seat once an hour. [00:40:05] Move around. Go to the ba. Just even just walk to the bathroom and walk back.
[00:40:09] Dr. Taz: I can
[00:40:09] Dr. Dan Ginader, DPT: sit,
[00:40:09] Dr. Taz: sit [00:40:10] for four hours straight.
[00:40:11] Dr. Dan Ginader, DPT: I know. Bad. I know. It's
[00:40:13] Dr. Taz: so bad. So
[00:40:14] Dr. Dan Ginader, DPT: bad. And if you don't [00:40:15] travel all that frequently, you're fine. And if you're not currently dealing with anything, it's fine. [00:40:20] But certainly if you are dealing with something. Getting up outta that chair, do some calf [00:40:25] raises, get some blood flowing. You don't even have to go to the bathroom, but walk to the back of the plane and walk back and [00:40:30] just breaking up that cycle of sitting can make a big difference.
[00:40:32] Dr. Taz: Do you like red light therapy for [00:40:35] muscles and mobility and some blood flow? And just curious, I'm just [00:40:40] thinking like maybe we can build a plane which has a red light bet in it, but anyhow, but I was just curious what you're thinking [00:40:45] about red. You know, you feel like some of these modalities help.
[00:40:48] Dr. Dan Ginader, DPT: I think modalities do have a place.[00:40:50]
[00:40:50] Dr. Dan Ginader, DPT: And one thing that my girlfriend and I kind of butt heads over Yeah. [00:40:55] Is that she is a modality girly.
[00:40:56] Dr. Taz: Okay.
[00:40:56] Dr. Dan Ginader, DPT: She loves a modality. Yeah. She loves
[00:40:58] Dr. Taz: give her a good red light bed [00:41:00] sauna full time.
[00:41:00] Dr. Dan Ginader, DPT: She loves red light. She loves that. She loves, uh, she loves stem. She loves all of that.
[00:41:04] Dr. Taz: [00:41:05] Yeah.
[00:41:05] Dr. Dan Ginader, DPT: And. She is a, she was division one athlete.
[00:41:09] Dr. Dan Ginader, DPT: Mm-hmm. She stays very [00:41:10] active. She understands all of the rules of movement and building strength. And so [00:41:15] for her, I think modalities are great. I just get worried about [00:41:20] recommending modalities to somebody who is already sedentary and already not moving.
[00:41:23] Dr. Taz: Mm.
[00:41:23] Dr. Dan Ginader, DPT: Because the mo, the [00:41:25] modality is not enough to move the needle or at least not move the needle [00:41:30] relative to how much, like building strength and, uh.
[00:41:34] Dr. Dan Ginader, DPT: Building mobility [00:41:35] and building flexibility can, and so I think mod modalities on top of a very [00:41:40] active person that is, is taking active steps of building strength is fine, but I don't like recommending [00:41:45] modalities to people who are not at least willing to try that first.
[00:41:48] Dr. Taz: So movement over modality a
[00:41:49] Dr. Dan Ginader, DPT: [00:41:50] hundred percent
[00:41:50] Dr. Taz: all the time.
[00:41:51] Dr. Taz: Yes. When you're dealing with. Pain prevention or active pain. [00:41:55] Let's go to maybe some other strategies around managing pain, which we've now [00:42:00] described, you know, multiple times as a complex inner web system, [00:42:05] not a singular point where maybe you treat a singular issue. The challenge with that [00:42:10] in our current medical model is that that's not how we think about pain at all.
[00:42:14] Dr. Taz: [00:42:15] And usually the way it goes down for most people is, you know, [00:42:20] presentation with pain. Pain medication of some kind. Doesn't have to be an opioid, but [00:42:25] some sort of pain management plan and imaging of some. [00:42:30] Kind, but there's not a lot of conversation around the role of inflammation, [00:42:35] the role of diet, the mind body component.
[00:42:38] Dr. Taz: And one of the things that Whole [00:42:40] Plus is, you know, that we're so passionate about is connecting the dots for people. So, [00:42:45] you know, for somebody who is in one of these scenarios that we've talked about, right, where. Sitting a [00:42:50] lot, they're traveling a lot. They're a performer of some kind. They're using their body [00:42:55] either excessively or not at all, you know, and they're at a higher risk [00:43:00] of injury.
[00:43:00] Dr. Taz: And that injury turning into a pain syndrome, you know, for those. [00:43:05] Folks as they're navigating their lives and then then navigating like [00:43:10] visits to practitioners. You know, what can we help them with? Like can we [00:43:15] give them or all of us something to really help us with, okay, this [00:43:20] is how we need to be thinking about it.
[00:43:22] Dr. Taz: These are the things that you need to be advocating [00:43:25] for because an image and a medication prescription may not be [00:43:30] enough to take care of what's going on here. How can we kinda line that out?
[00:43:34] Dr. Dan Ginader, DPT: So I [00:43:35] think that podcasts like this are really great resources for [00:43:40] people. 'cause I think it's really cool that there are so many different specialties.
[00:43:43] Dr. Dan Ginader, DPT: I think it's really cool that I [00:43:45] know a hip specialist. I think it's really cool that I know a knee specialist, but. The hip [00:43:50] and the knee generally work as a unit. They're connected. They're connected. They one can't move without the other. [00:43:55] Right? Yeah. And if you are going through a hip,
[00:43:56] Dr. Taz: you're a song. Your hip's connected to your knee.
[00:43:58] Dr. Taz: What was like elementary school song? [00:44:00]
[00:44:00] Dr. Dan Ginader, DPT: Right. I've
[00:44:00] Dr. Taz: remember it.
[00:44:01] Dr. Dan Ginader, DPT: We've known this for a really long time. Yeah. Um, and if [00:44:05] you see a hip specialist, they're only gonna talk about your hip. If you see a knee specialist can talk
[00:44:08] Dr. Taz: about,
[00:44:08] Dr. Dan Ginader, DPT: you need
[00:44:09] Dr. Taz: the most frustrating thing in [00:44:10] medicine today.
[00:44:10] Dr. Dan Ginader, DPT: Yes. And if you see a rheumatologist, they're only looking at one aspect of your blood work.[00:44:15]
[00:44:15] Dr. Dan Ginader, DPT: And I think we've lost, unfortunately. I think the [00:44:20] old school family doctor, old school general practitioner, yes.
[00:44:23] Dr. Taz: Thank you.
[00:44:24] Dr. Dan Ginader, DPT: Was one of the most [00:44:25] valuable things that people had access to. 'cause it was one of the few people that looked at everything. [00:44:30] They would ask about your diet, they would ask about your exercise.
[00:44:32] Dr. Dan Ginader, DPT: They would look at, we're
[00:44:32] Dr. Taz: gonna say that again because I think that's so important [00:44:35] and I'm, and I love that you brought that up and not me, because I feel like I'm always screaming and yelling about that. [00:44:40] But the old school family doctor was the quarterback. [00:44:45] For someone's health and the health of that family usually, and [00:44:50] so could understand in the ecosystem, right, what might be happening [00:44:55] for that particular patient in their family.
[00:44:58] Dr. Taz: Creating symptom X, Y, and [00:45:00] Z and what we have really found now, or landed in a place where [00:45:05] I think, you know, is scary when it comes to medicine, and this is where I say, yes, [00:45:10] absolutely, you guys are right. AI can replace doctors if we are going to practice [00:45:15] medicine like this, which is where there's, you know, there's a hand person, there's a hip [00:45:20] person, there's a head person, there's a heart person, there are all these people with no connector.[00:45:25]
[00:45:25] Dr. Taz: You know, it's actually why I started Whole Plus. Not to plug Whole Plus right now, but, but it [00:45:30] is what I am so passionate about that we can't have healing journeys, [00:45:35] we can't get people better, we can't get families better until we start connecting the dots. And [00:45:40] I love that you're saying that as well. So not to segue, but, but anyhow, go back to what [00:45:45] can the patient do?
[00:45:46] Dr. Dan Ginader, DPT: So if you are the kind of patient that is seeing a bunch [00:45:50] of these specialists, if you have a labral tear in your hip,
[00:45:54] Dr. Taz: yes,
[00:45:54] Dr. Dan Ginader, DPT: [00:45:55] go to the best hip specialist out there. Go to the person that is known for those surgeries. [00:46:00] Get your surgery done there. Follow the hip specific advice there. Do all of that. [00:46:05] Outside of something like needing a very specific surgery for a very specific problem, if you're the kind of [00:46:10] person that has a bunch of different specialists, which is very common here in New York,
[00:46:13] Dr. Taz: yep.
[00:46:14] Dr. Taz: Everywhere. [00:46:15]
[00:46:15] Dr. Dan Ginader, DPT: I think it's important to recognize that medicine is far [00:46:20] more nuanced and is far more gray than you may like it to be. [00:46:25] And when you're dealing with a specialist that is used to work looking at one thing, you're [00:46:30] better off just taking their advice with a grain of salt than going to your other practitioner, taking their [00:46:35] advice with a grain of salt and then sitting back yourself.
[00:46:38] Dr. Dan Ginader, DPT: And then unfortunately, you are now [00:46:40] in the position where you have to connect the dots, and it can be really tough if you don't have a medical [00:46:45] background. It can be really tough if you don't have other people that you can talk about this with, [00:46:50] but. I think the, the main, the main thing that is [00:46:55] hurting people right now, and this is something that I've learned especially working in the city and dealing with all [00:47:00] these people that deal with these, these specialists
[00:47:02] Dr. Taz: mm-hmm.
[00:47:03] Dr. Dan Ginader, DPT: Is they sought out the. [00:47:05] One of the world leaders.
[00:47:06] Dr. Taz: Right.
[00:47:06] Dr. Dan Ginader, DPT: I hear that too. Yeah. In, in, in their, in their field. And then they come [00:47:10] back and tell me that, oh, these, like they said, she said it was [00:47:15] this specific thing. And I was like, well, yes, like that specific thing is happening, [00:47:20] but what's to say that that specific thing isn't being inflicted because of the [00:47:25] lack of stability in your ankle?
[00:47:26] Dr. Dan Ginader, DPT: Or what's to say that that specific thing isn't only bothering you because [00:47:30] your diet is not good or. So I am lucky enough to work with [00:47:35] patients on a one-on-one, a one-on-one hour long basis, and we get to have those discussions. Mm. [00:47:40] So we get to start at the source. I have enough time where I can start at the source, right?
[00:47:43] Dr. Dan Ginader, DPT: And I can look at the thing that you came [00:47:45] in here with, and I can point out all the things that are wrong with it. And then as we go through this journey [00:47:50] together, as things get better and some things don't get better, then we have plenty of time for the [00:47:55] opportunity of. Oh, actually you did bring up that you had this knee injury.
[00:47:58] Dr. Dan Ginader, DPT: Let's, let's kind of dive into [00:48:00] that joint, or I've noticed that when you stand on that on your left leg, you're just not as stable. [00:48:05] Or I noticed that, uh, you came and saw me at 4:00 PM and every [00:48:10] time you see me, you're maybe a little spacey, and I, I get to ask you, do you eat lunch before you come here? [00:48:15] Or when's the last time you ate before you came here?
[00:48:17] Dr. Dan Ginader, DPT: And so we kind of get to, to tie the dots [00:48:20] together.
[00:48:20] Dr. Taz: I think that's such an important point that you really do need to have that advocate. That [00:48:25] is listening and observing and understanding that the body's interconnected. If a [00:48:30] patient doesn't have that person, how do they advocate for themselves?
[00:48:33] Dr. Dan Ginader, DPT: The squeaky wheel gets the [00:48:35] oil, and if you are not happy with the person that you're seeing, if you're not happy with your practitioner, [00:48:40] I think you owe it to yourselves politely, of course, to say, I don't think you're listening [00:48:45] to me.
[00:48:45] Dr. Dan Ginader, DPT: I don't think that this is right. I don't think that this is right. And then you may have to find someone [00:48:50] else because if you are, if you're seeing a [00:48:55] practitioner. That is in and out in five minutes, and that doesn't take [00:49:00] the time to look through your, your medical binder of all the different images that you've had and all the [00:49:05] different experiences that you've had.
[00:49:06] Dr. Dan Ginader, DPT: Then I think unfortunately it's time to find, to find someone new. [00:49:10] You just have to feel comfortable taking that agency over yourself and, and taking that [00:49:15] autonomy because we've kind of just like lost track of. How we can do that for people. [00:49:20]
[00:49:20] Dr. Taz: You know, I think, um, at, at a minimum, I think people get really stuck in this idea [00:49:25] that something like pain or fatigue or, you know, depression [00:49:30] or anxiety, that these things are, you know, not singular [00:49:35] issues.
[00:49:35] Dr. Taz: They are. Interconnected issues. Chronic pain will cause [00:49:40] depression and anxiety, right? Chronic inflammation will cause chronic pain. Depression and [00:49:45] anxiety are neuroinflammatory disorders. We can cut and paste this in lots of different ways, [00:49:50] but I think for the patient. What I'm hoping, and part of my motivation in bringing you [00:49:55] on is to really, you know, get that understanding.
[00:49:58] Dr. Taz: What I want the patient to [00:50:00] understand is that including myself, all of us, what I want all of us to understand is that [00:50:05] a holistic approach to pain is necessary, and [00:50:10] I think from a cultural standpoint, even as patients, we have to shift our mindset [00:50:15] too. Right, because I meet patients all the time, like I went to the best, blah, blah, blah.
[00:50:18] Dr. Taz: I went to the best [00:50:20] here. And they're running, they're like running in circles around the country, the city, the world, [00:50:25] whatever, doing that. But at the end of the day, the best of the best are only as [00:50:30] good as how connected they can create a plan for you to heal, [00:50:35] especially from something like pain. What is it that we [00:50:40] can do as we age to make sure we're pain-free?
[00:50:43] Dr. Taz: What would you recommend?
[00:50:44] Dr. Dan Ginader, DPT: [00:50:45] Move,
[00:50:45] Dr. Taz: move. Just move on. It's your number one rule move. It's just move everyone off. We're sitting doing this [00:50:50] podcast. I know. We need to get up
[00:50:50] Dr. Dan Ginader, DPT: and I'm already kind of getting to the point. I'm not sure how long we've been sitting, but I know it's time to move. My, my, my internal [00:50:55] clock is going off like, oh, I think it's time to, it's time to move.
[00:50:57] Dr. Dan Ginader, DPT: I think it's time to fidget it a little bit. Or it's, or it's time to, or it's time to [00:51:00] move and it, I know I've said it a bunch here, but it truly is, it truly is the secret. A [00:51:05] body in motion stays in motion. If you see a 90-year-old person [00:51:10] that looks, that has good posture and they look strong. I [00:51:15] if, if they're your grandparent, spend a day with them.
[00:51:18] Dr. Dan Ginader, DPT: I gu I guarantee [00:51:20] you they're not sitting for longer than 30 to 45 minutes. I guarantee you that if they're [00:51:25] sat for a while, they're getting up and they're going to the kitchen to do something or they're fidgeting around or I guarantee you, [00:51:30] if they're 90, if they're 90 years old and they're good posture and they're strong, they're running their own errands, they're going [00:51:35] on walks.
[00:51:35] Dr. Dan Ginader, DPT: I bet you anything that they're social, I bet they have like a bingo club [00:51:40] or I bet they have like a reading club or I bet so. It truly is [00:51:45] movement. It doesn't even have to be exercise. Going back to that 150 [00:51:50] minutes that the American Heart Association recommends. They classify gardening as [00:51:55] moderate exercise.
[00:51:55] Dr. Dan Ginader, DPT: They classify walking as moderate exercise. It doesn't have to be as [00:52:00] structured like
[00:52:00] Dr. Taz: you're sweating and dripping or lifting super heavy weights.
[00:52:03] Dr. Dan Ginader, DPT: Yeah.
[00:52:03] Dr. Taz: Or something like that.
[00:52:04] Dr. Dan Ginader, DPT: You just need, I [00:52:05] think the, the metric is like you just need to get your heart rate maybe in the triple digits somewhere. Mm-hmm.
[00:52:09] Dr. Dan Ginader, DPT: [00:52:10] Which is, is pretty easy for most folks to do. And so you can even shift away [00:52:15] from thinking like. I have to you, you should be lifting weights, like resistance training is wildly important as [00:52:20] you age. It maintains bone density. It maintains strength. Uh, a big reason why, [00:52:25] you know, the, the likelihood of death after a hip fracture is, is about five [00:52:30] years.
[00:52:30] Dr. Dan Ginader, DPT: It's not because the hip fracture is so. Traumatic. It's [00:52:35] because of the, the four to six weeks of bedrest that take place afterwards that if you [00:52:40] haven't maintained your strength and mobility and flexibility, that four to six weeks of bedrest [00:52:45] is, it can create enough atrophy and enough tightness to where all of a sudden you now struggle to [00:52:50] get in and out of a chair.
[00:52:51] Dr. Taz: Wow.
[00:52:51] Dr. Dan Ginader, DPT: And. That is why it's so [00:52:55] harmful. And so if you're maintaining strength, maintaining flexibility, maintaining your [00:53:00] movement, you are far more likely to be healthy in the long run. Strong in the long run, [00:53:05] and being that person that people will point to in the grocery store being like, wow, like I [00:53:10] bet you there.
[00:53:11] Dr. Dan Ginader, DPT: They're in their nineties and look at how, look at how well they move. It's because they, it's [00:53:15] because they never stopped.
[00:53:15] Dr. Taz: And that's such a message of hope and I, and I love that because it means that [00:53:20] longevity is movement and longevity is basically not being sedentary. Right. Let's do a quick, [00:53:25] rapid fire.
[00:53:25] Dr. Taz: I know we're running outta time and I want, I definitely wanna talk about your book as well, 'cause that's newly out [00:53:30] too. But quick number one, diet rule to prevent pain or if you're in pain. [00:53:35]
[00:53:35] Dr. Dan Ginader, DPT: More protein.
[00:53:35] Dr. Taz: More protein. Number one movement rule. If you're having [00:53:40] or experiencing pain,
[00:53:41] Dr. Dan Ginader, DPT: just do it more.
[00:53:42] Dr. Taz: Where does sleep?
[00:53:43] Dr. Taz: What would you say for folks [00:53:45] around sleep and stress if they're in chronic pain or experiencing pain? [00:53:50]
[00:53:50] Dr. Dan Ginader, DPT: That I think can get a little more complex, but I'm a firm believer that eight hours is the [00:53:55] minimum.
[00:53:55] Dr. Taz: Eight hours is the minimum. Mm-hmm. What about the people that skimp
[00:53:58] Dr. Dan Ginader, DPT: with people that skimp?
[00:53:58] Dr. Taz: I wouldn't know.[00:54:00]
[00:54:00] Dr. Dan Ginader, DPT: If you're skimping and you're in pain, then there's a good chance that you're just not getting enough sleep because [00:54:05] healing takes place while we're
[00:54:06] Dr. Taz: sleeping. While we're sleeping. So prioritize that sleep cycle. Mm-hmm. What is your [00:54:10] favorite modality? I know you're not a modality person. What is your.
[00:54:13] Dr. Taz: Favorite modality [00:54:15] for different types of pain and injuries that you see What really actually [00:54:20] works.
[00:54:20] Dr. Dan Ginader, DPT: It's a little controversial. Uh, in terms of this, like in terms of physical [00:54:25] therapists everywhere?
[00:54:25] Dr. Taz: Yeah.
[00:54:26] Dr. Dan Ginader, DPT: I do like a massage gun.
[00:54:27] Dr. Taz: Massage gun. Okay. I
[00:54:28] Dr. Dan Ginader, DPT: do like a massage gun.
[00:54:29] Dr. Taz: [00:54:30] Okay.
[00:54:30] Dr. Dan Ginader, DPT: I think that you can use a massage gun for just three minutes.
[00:54:33] Dr. Dan Ginader, DPT: I think inside of those three [00:54:35] minutes, it creates enough of a change to where you can reduce your symptoms a little bit and encourage [00:54:40] movement a little bit more. And it's also easy to use. It's kind of very intuitive. Uh, [00:54:45] I am a fan of massage gun, but I understand that that can be a little bit controversial.
[00:54:48] Dr. Taz: Best form of movement to [00:54:50] keep us living well into our sixties and seventies.
[00:54:53] Dr. Dan Ginader, DPT: Variety.
[00:54:54] Dr. Taz: [00:54:55] Variety. Okay.
[00:54:55] Dr. Dan Ginader, DPT: There's not one perfect form of movement. The best form of movement is a bunch of different kinds of [00:55:00] movement.
[00:55:00] Dr. Taz: Gotcha. Biggest emotional trap when it comes to pain and pain. Syndromes.
[00:55:04] Dr. Dan Ginader, DPT: [00:55:05] Helplessness.
[00:55:05] Dr. Taz: Helplessness. Say a little bit more about that.
[00:55:08] Dr. Dan Ginader, DPT: The people that struggle the [00:55:10] most with chronic pain have resigned themselves to the fact. That, that is how they're meant to [00:55:15] feel and that's how they're gonna feel for the rest of their life. Wow. It's that sensation of [00:55:20] helplessness that keeps people trapped.
[00:55:21] Dr. Dan Ginader, DPT: And then reason I try to find one small thing [00:55:25] to, to make a difference, and the reason that everything in the book, to plug the book [00:55:30] is so simple. Is because it's just meant to take that first step, and [00:55:35] if you can just take that one small step and make one small change, then it can just [00:55:40] shift that whole mentality from helplessness to a little bit of hope, and then you increase [00:55:45] your chances that you can continue on that journey enough to make a real difference.
[00:55:48] Dr. Taz: Oh, I love that. So tell us about the [00:55:50] book. We haven't talked much about the book. The book is newly out. What are you hoping to accomplish in the book? [00:55:55] We have it sitting right here.
[00:55:56] Dr. Dan Ginader, DPT: My goal with this book is that people will purchase it and keep [00:56:00] it in their house much in the same way they keep Advil or Tylenol in their house.
[00:56:03] Dr. Taz: Mm.
[00:56:03] Dr. Dan Ginader, DPT: Only now when they feel pain, [00:56:05] instead of reaching for the medicine cabinet, they reach for the book. They can reach for the book. Because I cover [00:56:10] every joint, I cover every muscle, and the most common causes of aches or pains in those areas. [00:56:15] I outline in very easy to understand language and in very short [00:56:20] segments why that?
[00:56:21] Dr. Dan Ginader, DPT: It may be in pain. And then at the end of every section I give [00:56:25] very accessible and easy to do mobility, flexibility, and strengthening exercises to [00:56:30] start moving in the right direction.
[00:56:31] Dr. Taz: Amazing.
[00:56:32] Dr. Dan Ginader, DPT: So it is that, that level one access to [00:56:35] information, that level one access to, to exercise and movement, to get you back on [00:56:40] the road to moving in the right direct.
[00:56:41] Dr. Taz: And the book by the way, is the Pain-Free Body and it's [00:56:45] available everywhere. Books are sold.
[00:56:46] Dr. Dan Ginader, DPT: It's available everywhere. Books are sold. Uh, it came out last week and it [00:56:50] did temporarily sell out at Barnes and Noble. Oh,
[00:56:52] Dr. Taz: wow.
[00:56:52] Dr. Dan Ginader, DPT: It temporarily sold out at Walmart. [00:56:55] Uh, currently there is still plenty of stock at Amazon and we're working on getting it.
[00:56:58] Dr. Dan Ginader, DPT: Uh, more stocked in, in Barnes [00:57:00] and Noble and Walmart. Incredible. But yes, it is, it is available theoretically, as long as it's not sold out [00:57:05] anywhere books are sold.
[00:57:05] Dr. Taz: I'm probably gonna steal that copy.
[00:57:07] Dr. Dan Ginader, DPT: Yes, it's all yours.
[00:57:08] Dr. Taz: Uh, I do wanna ask you one final [00:57:10] question. I have loved this episode, by the way. I think that I meet people in pain.
[00:57:14] Dr. Taz: My husband, as I [00:57:15] told you, has, uh, a little bit of a pain issue and I think. The message [00:57:20] that he gets from his providers or that my patients are hearing outside of my [00:57:25] exam rooms or exam rooms at Whole Plus is not often one that is [00:57:30] driven towards resolution of pain and pain syndromes, right? It is usually very fixated [00:57:35] on here's the injury, here's the image, here's the medication.
[00:57:38] Dr. Taz: The end, and I [00:57:40] love that this conversation hopefully opens up the minds of both doctors and providers and patients [00:57:45] as well to think in a little bit of a different way. So thank you for that. I really appreciate it. [00:57:50] And for you, I wanna know what makes you whole.
[00:57:52] Dr. Dan Ginader, DPT: What makes me whole? [00:57:55] I think it's movement and I think it's variety of movement.
[00:57:57] Dr. Dan Ginader, DPT: Variety of movement. Yeah. I think [00:58:00] it's, I, I do try to practice what I preach and I do try to challenge [00:58:05] myself to move in different ways. It could be in the clinic, if I give a patient an [00:58:10] exercise that I've never really. Done for myself. I will try alongside with [00:58:15] them. Uh, my girlfriend goes to, she loves a group, Pilates
[00:58:19] Dr. Taz: class.
[00:58:19] Dr. Taz: Yeah. I'm right [00:58:20] there with her.
[00:58:20] Dr. Dan Ginader, DPT: I'll go to solid core with her. Yeah. Uh, I try to, I try to find ways to [00:58:25] maintain that variety and then find out what I'm not good at. So I can work on it and get better, and then I [00:58:30] know that that will reduce my likelihood of, of being in pain and increase my likelihood of living a [00:58:35] strong and healthy life.
[00:58:35] Dr. Taz: I love that variety of movement. Well, thank you so much for taking time outta your [00:58:40] schedule to join us today. I hope for all of you watching and listening to this episode, a whole plus, [00:58:45] you'll help someone who is suffering from pain and share this with them, and I will hopefully [00:58:50] see you guys next time.
[00:58:51] Dr. Dan Ginader, DPT: Before you go, take a second to reflect on what stood out [00:58:55] for you today. Then
[00:58:56] Dr. Taz: if you can leave a quick review wherever you're listening, [00:59:00] it really helps other people discover Whole Plus and start their own healing journey. [00:59:05] And don't forget to follow me on Instagram at Dr. TAs md. I love hearing how [00:59:10] these episodes are supporting you.