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Parkinson’s: An Athlete’s Journey is for athletes navigating Parkinson’s, the coaches and clinicians who train them, and anyone who wants real-world strategies for performance and longevity. Hosted by Eric Von Frohlich and Todd Vogt, the show focuses on tactical takeaways: how to train, recover, manage symptoms, and stay consistent when the rules keep changing. Expect honest conversations, tested routines, and guest experts who go deeper on what works.
Eric Von Frohlich (00:33)
So Ryan, welcome to the show and
just gonna kind of dive in, but before we get going on the Rock Steady boxing stuff, why don't you tell my listeners a little bit about yourself and how you got involved with Parkinson's?
Ryan Cotton (00:45)
Yeah, th thanks for having me. And Eric, you left out that you're an integral piece of the board of directors of Rock Steady Boxing now. So I appreciate your service to our to our organization and all your expertise that you bring. So yeah, I was I was a physical therapist. I graduated this many gray hairs ago, so ⁓ quite a while ago and was in clinical practice in Indianapolis for north of twenty years.
Eric Von Frohlich (00:51)
Well
Ryan Cotton (01:12)
During that time I did a doctorate of health science degree and when I was finishing that degree in two thousand and six
aligns with when Rock Steady was starting as an organization. So in 2006, our first group of folks with young onset Parkinson started getting together and exercising doing what is now the curriculum of Rock Steady boxing. started getting together and they they realized they were onto something. Their symptoms were getting better. And so in about 2008 they were developing their first board of directors and as a at that point a young physical therapist
I just finished my doctorate degree. I had relationships with some people that were on the board. And so they invited me as a medical provider to be on the board give them guidance in what the curriculum should look like. And when I came on the board, we were one location in Indianapolis in
In an aerobics room that sat up and tore down for every class. ⁓ and as I sit in headquarters today, we are eight hundred and forty-seven locations, ⁓ sixteen countries around the world, every state. and so my initial involvement was because I was a physical therapist and had a t a a terminal degree. About three years after I was involved on the board of directors, my father was diagnosed with Parkinson's. ⁓
Eric Von Frohlich (02:32)
it's ironic.
Ryan Cotton (02:33)
Yeah, yeah, it certainly is. So it went from a kind of a professional mission to a very personal mission to balance out my professional mission for the organization.
He was never an exerciser. He agreed to be a control group ⁓ in any study that we did because there's no way he was going to Rock Steady. ⁓ and he and he said that for years until he stopped saying that. Eventually he went to Rock Steady, which is kind of a funny I was in a board meeting and got a message. Hey, I went to Rock Steady today for the first time. This was from my dad. He said, It wasn't too bad. I I did pretty well. And keep in mind he wasn't an exerciser. And then a couple
Eric Von Frohlich (02:52)
Right.
Ha ha ha.
Ryan Cotton (03:12)
of days later, I got a follow-up message from them that said, by the way, I I went to Rock Steady today and about didn't make it through the warmup. So ⁓ so they must have gone easy on the greenhorn the first time and then really put it on them the second time. But I all that to say, like so many people, there sometimes there's some questions about what is Rock Steady class. Sometimes I truly think my dad didn't want to, his principal symptom for a long time was just a hand tremor.
And he didn't want to see what the disease could progress to. ⁓ but what I think so. I think so. It's scary, right? Progressive degenerative neurologic disease. That's a scary term. and if my hand's just tremoring, hey, if this all it if this is all this disease is, I want to keep my focus on that. ⁓ but
Eric Von Frohlich (03:47)
Right. I think that happens with a lot of people.
Exactly. It it
is ironic how symptoms seem to pop up the more you look into it, the more you seem to manifest the symptoms that you end up reading or studying.
Ryan Cotton (04:16)
Yeah, yeah. once he started class he he never stopped until his last days.
He died in twenty-three. So even over COVID, he would join our Zoom classes at headquarters. He's not from here. He's about two hours north of here. but I would see him on Zoom and so like so many, once he started, he was a servant to the gym and his fellow boxers. yeah, what started as a professional mission became a very personal mission once my dad was diagnosed.
Eric Von Frohlich (04:44)
Yeah, I would image. What drew you to health care initially?
Ryan Cotton (04:48)
that's a good question. my mother was an elementary education teacher. And she stayed home after I was born and my siblings were born. My youngest sibling was born with Down syndrome. and when my mother went back to work
She went back to work and teach in the special education world. And this was in the early 80s. and she was part of an organization that opened a school and after school center that integrated kids with special needs and kids without special needs in the same class, which
Eric Von Frohlich (05:27)
Wow, it's
super progressive, right?
Ryan Cotton (05:29)
Now is completely normal. In 1980, that was crazy. but so my mom, her her second half of her career was in that lane, where which there was always physical therapy. So she had physical therapists at her school and she said, Hey, I know what you like, and why don't you come see what the therapist does?
My mom introduced me to the profession of physical therapy. I came and hung out with that therapist, quickly realized I didn't want to work with kids, but ⁓ I was I was an athlete and that kind of fit the need of in the medical lane, but more time with the patient, more active role. And ⁓ so yeah, the rest is history. I went to the University of Evansville and did undergrad and therapy school there.
Eric Von Frohlich (06:00)
Right.
Ryan Cotton (06:16)
And then several years later went to the University of Indianapolis did Doctor of Health Science there.
Eric Von Frohlich (06:22)
Fantastic. And there was a any specialty to that turned you to Parkinson since you didn't have it in your family at the time?
Ryan Cotton (06:30)
No, just the invite to Rocks City Boxing. So in the therapy world, I was mainly a shoulder and spine guy. so my doctoral dissertation is on a a predictive model for shoulder pathology. but
My relationship with Rock Steady Boxing, the coaches here at headquarters would frequently refer boxers from headquarters to me in the clinic. know, Rock Steady Boxing is typically delivered in a group setting. and sometimes disease progression or an injury might require some individual attention from therapy. So coaches would refer Rock Steady fighters to me. I would work with them individually and get them.
back to the gym so they could continue participating in Rock Steady Boxing. Sometimes they would send participants to me before
they started in class. You know, like my father, maybe they were apprehensive, maybe they had balance challenges or whatever. So they would benefit from one-on-one work with a therapist before joining the Rock City class. So that was another professional integration I had with the organization where I saw people referred specifically from Rock City Boxing Gyms. And I think that's an essential to gyms today across our network.
And we really promote that our Rock Steady gyms are part of that Parkinson's community where they have a referral network of movement disorder specialists, all the therapy disciplines, PTOT speech, that they're really well equipped for the boxers in the gym when they need specialized care, that they have trusted resources where they can refer folks.
Eric Von Frohlich (08:14)
In regards to Parkinson's, is there a a list that you just kind of rattled off that you want to give some clarity to, the difference between an OT, a PT, a movement specialist, a neurologist, a neuroscientist? There's a lot of terms that get thrown around and and I don't know that people necessarily realize that they're specific certain degrees or certain how you spend your time in clinics.
Ryan Cotton (08:39)
Yeah, it takes a village, right? Like
When I describe Parkinson's symptoms to people, there's the the four main symptoms, the tremor, the rigidity, the dyskinesia, echinesia, and the postural, you know, the kind of the forward-stooped posture. Those are the typical physical symptoms that people see. But then there's the whole lottery ball, you know, the you know, in the when they draw the lottery, the spinning balls where they reach in and grab it. I think
Eric Von Frohlich (08:59)
Mm-hmm.
Right.
Ryan Cotton (09:12)
Everyone with Parkinson's reaches in and that bucket has a hundred symptoms and they reach in and maybe they pull out three extra and maybe they pull out thirty extra. But that's why I say it takes such a team between
Eric Von Frohlich (09:22)
Right.
Ryan Cotton (09:28)
Physical therapists who are really your your movement experts and can help with some of that. Occupational therapists, which can help with some of the functions of daily living, speech therapists, which can help with speech, which is muted with with Parkinson disease, but can also help with swallowing, which is a significant symptom of Parkinson disease. And on your on the medical side, having a neurologist but
To me, very importantly to have that neurologist be a movement disorder specialist that specializes specifically in movement disorders like Parkinson disease is so helpful in the overall management of the symptoms, I mean the peripheral specialties include
optometry specialists that can address some vision symptoms, sometimes some dizziness and balance experts if there's any of that So there's such a broad list of depending on what balls you pull out of the lottery what kind of specialties you need to surround yourself with.
Eric Von Frohlich (10:31)
I like the idea of the ⁓ the analogy of a lottery bucket as opposed to whack-a-mole.
Ryan Cotton (10:37)
I don't know if is lottery the correct term, like it's the lottery no one wants to win, right?
Eric Von Frohlich (10:42)
Right.
Exactly.
Ryan Cotton (10:45)
I I say
that about Rock Steady gyms and I mean it with seriousness, right? Like you're now part of the club that no one ever wants to be part of. And the community that happens in Rock Steady Gyms is so important to those fighting Parkinson disease. They get I say sometimes you get the support of a arm around your shoulder and commiserating and with great empathy and compassion. And sometimes you get the support from a colleague of a foot in the backside that says, you know, let's get going and let's get some stuff done ⁓ enough.
So to me that community is so important when when fighting Parkinson disease because it's a, as you know, it's an all-encompassing all-day management of that disease and having that community around you so important.
Eric Von Frohlich (11:31)
Yeah, do you have any words of advice for someone who's recently diagnosed about what they should jump into from a support perspective? I think you've touched on it wide wide scope, but maybe something a little more specific and it's your first time you just got diagnosed and you're looking for some support or you're looking for some movement specialist, what what direction could you send someone?
Ryan Cotton (11:54)
on the medical side I think it is finding the movement disorder which the unfortunate component is the it's difficult to find a movement disorder specialist. My father, for example, lived in the second biggest city in Indiana. He had a neurologist, but once a year he traveled and a half hours to Indianapolis to see a movement disorder specialist. And even that's okay, right? Just have that person as part of your team. Your neurologist can do your day-to-day.
but having just that extra set of eyes of the movement disorder specialist is good. the other advice is is great advice I heard once from with Parkinson's. They said when they were diagnosed, their physician said, I want you to do three things. Take your medicine on time. We all know that the timing of the medication, so important. two,
Eric Von Frohlich (12:37)
Right. Yeah.
Ryan Cotton (12:42)
Figure out what is your exercise. That is part of your medicine. Figure out the exercise medicine that works for you and stick to it. Be consistent with it. In our case, our delivery of medicine is boxing-based training.
It could be cycling, it could be rowing, it could be climbing, it could be ping-pong. Figure out what it is and stick to it. And it can be a variety, just stick to it. And three is develop your community and keep a positive attitude. So lot of times, number two will contribute to number three, right? That exercise group can become a resource and become that supportive community. But if you need beyond that, if you need specific support.
Eric Von Frohlich (13:16)
Yeah.
Ryan Cotton (13:26)
Find it in friends, find it in family, or find it in a very purposeful support group that is for people with young onset Parkinson's. It's people working that still working that have Parkinson's. It's spouses of people with Parkinson's. Whatever that group you need for support, be sure number three, you have that right community around you to give you the support and keep you in a positive direction.
Eric Von Frohlich (13:52)
Yeah, getting your mindset established early on and how you want to deal with this is paramount to success. I kind of find that, you know, you you have to adjust every morning to symptoms that are in front of you and how your body's responding. But you need to really have a gratitude and a breath practice and all the things that make it
manageable to have a positive outlook and to have a community around you supporting you because without that you're kinda lost.
Ryan Cotton (14:21)
Yeah, that ⁓ let me be the question ask. how how do you do that? Like the number three on that list was maintain that positive attitude, which is easy to say, right? Be be positive, but you also have a progressive degenerative neurologic disease. So how do you how do you do that? Like what are your mechanisms to maintain that positivity and that support you need?
Eric Von Frohlich (14:34)
Yeah, and it it
Well, it's funny because I was just evaluating that specific question, in that I broke the rhythm of everything I had been doing previously when I went through the ablasion my AFib and my stint. It was about six months of procedures because there was a three month gap in between them. And it kind of interfered with my morning ritual, which was get establish my mindset, be grateful.
Find the things that you want to, you know, experience in your day, expect greatness and opportunity thrive and try to get that all dialed in. And then I go stare at the sun for a couple of minutes, get some low angle sunlight in my eyes, I do some breath work. So I try to build like small stackable wins of things that I control so that it just builds momentum into the things that I can't control.
And gives me a better outlook and a better better attitude towards you know, what I'm dealing with.
Ryan Cotton (15:38)
Yeah.
and to the listeners, we didn't plan to have this discussion, but we're having it anyways. That's super Yeah, that's super interesting because you had your plan and your plan was working, right? Like this is this was my morning set, and it was really working for me. And then this medical procedure interrupted that, and your Parkinson symptoms.
Eric Von Frohlich (15:48)
That's because you asked the questions.
Yeah.
Ryan Cotton (16:05)
responded in not the right in a predictable but not a not a positive fashion when that morning set was interrupted.
Eric Von Frohlich (16:12)
without question. My wife constantly tells me like what a creature of habit I am and how important it is because, you know, you your mindset's kind of fragile. And, you know, if you don't get it dialed in, it kind of, you know, it's kind of an unwieldy child that just kind of runs away with you and ⁓ and you spend the day wondering, yesterday I had a moment where I was we're move we're in the process of moving because
Ryan Cotton (16:22)
Yeah.
Eric Von Frohlich (16:38)
Traveling and summertime with the kids out of school and everything else that was going on was just too easy. So he threw in a couple of procedures for me and decided we'd move at the same time and go to Alaska for a family vacation just to kind of round it all off. but I had a moment yesterday where I was just completely overwhelmed by what was in front of me for this week. And I was I had to like literally give myself the grace to step back and have a moment and say, like.
Ryan Cotton (16:52)
Right.
Eric Von Frohlich (17:04)
It's okay to kind of freak out a little bit and get a little caught up in the moment, but what can I control and what can handle? And so I went back to my breath work. My breath work got me in the right frame of mind. And then from there I established my gratitude and I just kind of started to rebuild that little system that I had that was working so well. And sure enough, the ship kind of righted itself and kind of felt a little bit better. And as soon as you feel a little bit better, you feel like you have a little more control.
And everything starts to roll in the right direction.
Ryan Cotton (17:35)
Yeah, that's pretty interesting. Your body was so in sync with that check, right? You'd done that check so many times, you just had to revisit it and it kind of rewired you. That's interesting.
Eric Von Frohlich (17:42)
Yeah.
Yeah, it's the whack a mole is is legit. You're not sure whether it's gonna be a ⁓ brain fog or if it's gonna be one of the procedures that complicated me was I was fasting before the AFib and or procedure. And so the fasting rolled into the procedure and then I didn't have a bowel movement for isn't unfamiliar to Parkinson's patients, but
the all the medication I was on exacerbated bowel movement, my gut motility, and I ended having a bowel movement for like six or seven days. So I got impacted and that kind of led to some gut issues and some it kind of threw the whole thing sideways. But sure enough we're working our way back better times.
Ryan Cotton (18:36)
Yeah, there you go. The the reset is underway.
Eric Von Frohlich (18:39)
So did you when you started with Rock Steady, did you always have a leaning towards leadership or was this something that you kind of found through the organization?
Ryan Cotton (18:49)
Well when I came on the board, it was interesting. There the board was mainly very accomplished professionals in the Indianapolis area. Our founder, Scott Newman, was the prosecutor of Marion County, ⁓ which is Indianapolis, Indiana. So he was a a a very well recognized, very well respected figure in the community. So this board was populated with
Eric Von Frohlich (19:04)
wow.
Ryan Cotton (19:15)
people of his ilk and I was a you know a 30 year old greenhorn physical therapist that just went to school a long time and could I could tell him what was going on in the literature. So no when I came on I was a quiet dude in the corner trying to learn from this from this group of experts. over time I was a owner of
Eric Von Frohlich (19:24)
Ha ha.
Ryan Cotton (19:38)
our physical therapy practice, one of the partners in the practice. And so by that I always had leadership roles. when I did my doctorate work, my plan initially was to go into university education to become a physical therapy instructor. which I was my degree and afterwards.
Eric Von Frohlich (19:54)
Mm-hmm.
Ryan Cotton (19:58)
And when I was selling my practice, that was my goal. I was gonna return to the university in a full-time faculty role. At the same time, this was 2018, 2019, Rock Steady was tweaking and refining their curriculum and they had never had a
scientific officer or medical officer on staff. I was brought on in 2020 as the chief scientific officer to guide research and to to lead the refinement and revisions to our After doing that for two
Two, two and a half years, I was transitioned into the role of chief executive officer. So I'm in the seat I am in today by no plan of my own, right? I went from a volunteer on the board to the the educator and very purposeful position in the organization to then leading the whole organization. And when I was when I was offered the position,
You know, I'd I'd owned my own company before and I didn't have any aspirations of being the guy in charge again, right? I I'd done that. but at the same time, I was well equipped to be in my seat, right? I'd been around the organization since we were one location.
Eric Von Frohlich (21:11)
Right.
Ryan Cotton (21:24)
one location in Indianapolis with 30 boxers to now over 800 locations around the world. I understood thoughts of the organization when they were developing and what they kind of wanted to accomplish.
And being the chief scientific officer, I understood all the science and the curriculum behind it, but also the importance of having the consistency in how we deliver the education to really prepare those coaches of ours at all those affiliate locations to be delivering the current best practices. And when we say boxing for Parkinson's disease, people think, I can just go to any gym and do throw some coaches on a heavy bag. Our curriculum is based on boxing.
Eric Von Frohlich (22:04)
Boxing, right.
Ryan Cotton (22:09)
It's non-contact, but it's completely tweaked to address the symptoms with Parkinson disease, right? So the motions are big, the motions are exaggerated, there's lots of trunk rotation, there's lots of footwork and balance work. There's
Dual tasking where we're challenging the brain and the body at the same time to work on some of the wiring responses in the brain. So having that curriculum so specifically directed towards the symptoms of Parkinson disease, I think the fact that I'm I've been in all those different chairs has perfectly prepared me to be in the chair I am currently for the organization.
Eric Von Frohlich (22:50)
Well, did you actually see the growth happening or did it kind of take you by surprise?
Ryan Cotton (22:55)
That's a great question. And that's the same question so I mentioned Scott Newman, our founder, the the prosecutor.
He founded this in 2006. Last week he was in the gym, right? So he still comes to Rock Steady. Last week he was in the gym and I asked him that exact same question. we're coming up this October is 20 years we've been around. And I said, Scott, when you first started boxing with Vince, Vince his a law partner a cop that that trained with Scott. I said, When you first started boxing with Vince.
Did you know that this would become what it is today? or were you just doing it to make your symptoms better? And then you invited your friends to do it so their symptoms would get better. He said, Well, A, I knew my symptoms and I wanted my friends to get their symptoms better, but I knew we were onto something. He said, He said, In the same year I started
Eric Von Frohlich (23:41)
Right.
Yeah.
Ryan Cotton (23:57)
A nonprofit, Rock Steady, and I started a new company which was a no-profit. So of the two things I started that year, I knew one was gonna be successful in a big deal, and it was Rock Steady. So from the beginning, and
I can confirm that anytime someone's exposed to a Rock Steady class, they get their hair blown back a little bit. I was a physical therapist before I came on the board. They're like, come see a class. and you know, you do a double take. What's going on in this class? It's intense. It's, you know, all this agility, all this, all this strength, all the flexibility, all the functional drills people are doing. You know, when you walk into a gym, something special is going on. And he confirmed that with his answer. He's like, I knew we were on.
Eric Von Frohlich (24:20)
Yeah.
So what makes exercise so important to Parkinsons?
Ryan Cotton (24:49)
it's dopamine, my friend. the natural response that I get when I exercise, release of dopamine, principal cause of the symptoms of Parkinson disease is decreased production of dopamine and the decreased body's use of dopamine as a neurotransmitter. So the normal response to exercise for everybody is a bump in dopamine. That's
Exponentially more important for someone with Parkinson disease who lacks that dopamine function and lacks a quantity of dopamine in their neurotransmitter system because of their disease process. We now know
So d ⁓ I'll tell a little story. I remember back in the early days of Rock Steady Boxing, we were in a we were in a board meeting and Scott was still on the board at this time and he was a prosecutor, so he was fiery, right? And I remember him kind of
Eric Von Frohlich (25:43)
Ha ha.
Ryan Cotton (25:45)
d like trying to make a point. He was tapping on the table and he said, Man, he's like, we're on to something. If only the science would catch up with us. We know we're making people better. If only the science could say we're slowing the disease progression, that we're changing the progression of the disease. Well
Eric Von Frohlich (25:58)
Right.
Ryan Cotton (26:01)
Fast forward to about two or three years ago, right? That science is now coming out where the only disease modifying intervention, no medications, no stimulation, no whatever, the only disease modifying intervention for Parkinson disease is regular, consistent, moderate to high intensity exercise. So what he was so insightful thinking about in 2000, that was probably 2008, 2009, is now on the
Scientific table that the science has caught up with us and said that the exercise itself modifies at the brain level, reconnects some new pathways, slows the progression of Parkinson disease. You still get the physical benefits of exercise: better strength, better endurance, better balance, better mobility. but you also get brain change with the exercise, which is so important for the Parkinson's population.
Eric Von Frohlich (26:58)
So what so you just ran off a list, but let's run through it again. What's the benefit that someone can expect from starting rock steady boxing?
Ryan Cotton (27:06)
Yeah, so you get all the physical benefits. So the the the science that's out there shows regular participants in Rocks City boxing or similar exercise, decrease falls, decrease hospitalization, better increased gait speed, decrease in
Non-motor symptoms, so non-motor symptoms being less apathy, less depression, less anxiety, those are all decreased as a response to exercise. And now we know you can slow the progression of the disease with regular, consistent, moderate to high intensity exercise.
Eric Von Frohlich (27:50)
Yeah, it's remarkable. It's a it's like a blessing for someone who's an exercise junkie.
Ryan Cotton (27:55)
Right.
Eric Von Frohlich (27:58)
Right. Like it's
the best excuse. It's like, honey, I have to go work out for the third time today.
Ryan Cotton (28:03)
Yeah, in the exercise world, I'm sure you've heard it even before Parkinson disease, if they could package up all the benefits of this into a pill.
Eric Von Frohlich (28:13)
Yeah, it'd be the most powerful drug in the world.
Ryan Cotton (28:15)
Right. And there it is. It's available to all of us. it's the ability to get up and exercise and challenge ourselves, right? That all those benefits are packaged up in that little that little pill that you have to take.
Eric Von Frohlich (28:29)
Yeah, the
I think the trick is the avoiding the apathy. I noticed that when I was looking at dopamine that the it wasn't so much the pursuit of pleasure, it's the pleasure of the pursuit that's important. And so it's not it's not the event itself, it's the of going through the exercise that's really emblematic of the lack of dopamine. Have any tips for overcoming apathy?
Ryan Cotton (28:42)
Right.
Yeah.
Boy, that's a tough one. I mean the the easy answer is you know the old Nike just get out and do it. Just just commit yourself to it. and that's that's easy to say and hard to do. To me, the best answer is we know that exercise is so important.
Eric Von Frohlich (29:07)
Yeah.
Ryan Cotton (29:18)
We know that the exercise needs to be multimodal in the fact that it's some endurance, it's some strength, it's some balance, it's some cognitive challenge, but it can be delivered in so many different ways. And trust me, boxing isn't for everybody. if boxing's your thing and you love it,
Do it and make it your thing. ⁓ but some people love cycling, some people love ping pong. What to me, the best way to fight apathy is to not make the pill that you're taking bitter, right? You want to enjoy it. So figure out what exercise you enjoy. The exercise is the most important part. The enjoyment keeps you doing it. so we have, yeah.
Eric Von Frohlich (29:52)
Right.
Right. And hopefully it has a community around it.
Ryan Cotton (30:05)
Yeah, and we have a lot of people that come here to to headquarters that they might box two days a week and then they might cycle one day and they might ballroom dance one so you know whatever your mix of exercise make sure it's appealing to you. And that to me that's at least the best way address apathy the best you can is find what's enjoyable for you rather than
gritting your teeth every time you have to go exercise, that's apathy's gonna win that battle a lot.
Eric Von Frohlich (30:34)
Yeah, that's definitely true. It's something apathy was something that really wasn't prepared for as a non-motor base symptom. So it kind of came on the heels of depression. it was primarily because at the time I couldn't exercise. I had a a psychosomatic event that resulted in a back injury really work out. So I went from working out two, three times a day.
To not not be able to walk the dog more than 10 feet without having to stop and stretch and kind of ease off my symptoms. And then the apathy and the lack of community quickly much more of a thing that I had to figure out how to overcome. was essentially what you recommended: getting back to a sense of community and finding support and finding an activity that I love. So
Ryan Cotton (31:01)
Yeah.
Eric Von Frohlich (31:20)
and jujitsu were the two things that I was doing beforehand. And they seemed to complement each other in lots of ways. So the racket sports and the community of pickleball was offset by the intensity and the intimacy of jiu-jitsu. And so, you know, and then I've just been adding pieces and as soon as I got community around me, apathy seemed to take care of itself.
Ryan Cotton (31:35)
Yeah.
Yeah, that's a that's a great point. The the exercise is so important and frequently with the exercise there's the community that comes with
Eric Von Frohlich (31:54)
Yeah, I mean that's one of the beauties of Rock Steady Boxing is the sense of community around it and the sense of, you know, common goals and similar support what makes it so special.
Ryan Cotton (32:05)
Yeah, yeah.
Eric Von Frohlich (32:07)
So what are some of the social or emotional transformations you've witnessed through Rock Steady Boxing? Any stories come up that you'd wanna share or that jump out at you over the years?
Ryan Cotton (32:17)
Well, I mentioned my dad that never wanted to be in a boxing class, but once he started he never quit. And he was it's interesting in my job I it's not uncommon that I visit different affiliate locations and I see the same cast of characters just dressed up in different bodies. yeah. So my dad
Eric Von Frohlich (32:36)
It's very true.
Ryan Cotton (32:40)
I am my father's son. My dad was the the quiet guy in the back that was observant, but he was also the connector. and so if you know if a boxer had missed a week or two, my dad would reach out and hey, what's going on? Anything we can help you with? and eventually he became the the go-to for the coach at his location. Hey, can you check on can you check on Jim? Can you check on Jane? Can you check on Joe? Whatever. so
it's always interesting when I go to an affiliate location to see the, you know, there's the jokester and there's the cheerleader and there's the, you know, the the grumpy dwarf, right? You you see you you see them all at the at
Eric Von Frohlich (33:21)
It is a sitcom
and in if you have the the right vision, it's it's the office without question.
Ryan Cotton (33:28)
I would just thought the same thing. If we could create an office version of Rock Steady, you know you know all all the characters are there for sure, yeah.
Eric Von Frohlich (33:36)
That's very true. what do you think the people living with Parkinson's need the most from this support system? Is it the accountability or is it something that I'm not that I may not otherwise recognize?
Ryan Cotton (33:50)
it it's definitely accountability is one component. support and compassion and information is the other, right? So I talked about the arm around the shoulder or the kick in the pants, right? Like that sort of support.
Eric Von Frohlich (34:05)
Yeah.
Ryan Cotton (34:08)
But also the information, right? Like you see people doing their warm-up in the gym where they might be, you know, doing some laps around the gym or whatever before class and they're s you know, they're talking about, hey, I've I've got this symptom. What have you done for that? Hey, you know, my I have hypertonicity in my toes and they're curling up. What shoes do you have you tried? You know, just off the cuff information and discussion that doesn't happen.
Eric Von Frohlich (34:25)
Right.
Yeah.
Ryan Cotton (34:36)
in a support group or doesn't happen with your doctor. And frankly, it doesn't happen without a colleague that is fighting the same thing. Right? You might say, I don't have that trouble, but Joe over there has the toe trouble. Go talk to Joe. He'll figure it out.
Eric Von Frohlich (34:46)
Right. Yeah.
Exactly, particularly for men to have a support group is not a not a common thing as of yet. So to to be able to lean on each other and kind of find some mentorship or some people who've been dealing with this a little bit longer than yourself is certainly comforting.
Ryan Cotton (34:58)
⁓
Yeah, that that's a great point in it. maybe men don't
Don't recognize out loud that what goes on in that gym has a support group component to it, right? They're just say, Eric helped me figure out what shoes I w wanted to wear, right? So whether that support group or it's just Eric who had Parkinson's help me out, whatever you need to call it. But yeah, that sort of thing definitely happens. You you asked about transformation. Let me tell you about a great transformation.
Eric Von Frohlich (35:23)
Right.
Ryan Cotton (35:38)
There was a guy with young onset Parkinson's that like most folks, I think, with young onset Parkinson's, once he was diagnosed, he was pretty ticked off and sat at home and was mad about it, right? So, and he he degraded pretty quickly because he wasn't doing anything. Well, this young man was a retired and decorated Marine. And
Eric Von Frohlich (35:52)
Yeah.
Yeah.
Ryan Cotton (36:05)
Long story short, his wife tricked him into coming to Rock Steady for an assessment. And he was pissed when he got here because he he was duped. and so he was he was not very cooperative and he wasn't very nice to our coach who was doing his assessment. But
Eric Von Frohlich (36:14)
Right.
Ryan Cotton (36:25)
Fortunate for him and fortunate for the coach, she was the daughter of an ex-military. And she she called him she called him on the carpet and she said, Listen here, Marine, this is not behavior becoming. And until you're ready to do something positive, get out of my gym and come back here when you're ready.
Eric Von Frohlich (36:34)
Sh, sh.
Wow.
Ryan Cotton (36:47)
And so he snapped to and participated begrudgingly, now at least respectfully participated and started in our program. And when he came to the started coming to the gym on a good day, he was on a cane and on a bad day he was on a walker and would get here early and stash him in the corner because he had young onset and he was a retired military. well
Like most folks with young onset, if they ignore the symptoms, they progress quickly. If they address the symptoms, they would they improve quickly. Well, within months, he had ditched the walker, he had ditched the cane, and within several months he was doing a 5k, and within a year, he did a half marathon. and
Eric Von Frohlich (37:29)
Amazing.
Ryan Cotton (37:31)
Part of that was the physical response, but to our earlier discussion, so much of that is a psychosomatic response, right? Like he he checked out. He was ticked and he checked out. And when he rolled into the gym, he saw people fighting the same fight that he was fighting, that he could put his arm around or put his foot in their backside, and they could do the same to him. And it changed the trajectory of his disease.
Eric Von Frohlich (37:40)
Yeah.
It's amazing. I mean, you've had such a unique perspective leading the organization through the years. Is there any other stories that jump out at you that you that were most impactful?
Ryan Cotton (38:13)
the the ones that are always head scratching to me are I might get choked up a little bit about this, the people that leave the gym thankful for their diagnosis.
Eric Von Frohlich (38:30)
Yeah, it's remarkable, isn't it?
Ryan Cotton (38:32)
'Cause it it refocused them on what was important and cut out all the BS that wasn't. And I can't imagine being thankful for the diagnosis. But they are.
Eric Von Frohlich (38:46)
Yeah, it's
we we talk about it quite a bit in that it's it's been a blessing in in disguise because I've come to know people that I never would have met otherwise. And I've learned patience and compassion in a degree that I never could have been capable of doing earlier. just the amount of fortitude and resilience that I've seen in the in some of my guests has inspired me to say, wow, I'm really
Ryan Cotton (38:56)
Right.
Eric Von Frohlich (39:14)
leaving a lot on the table. I need to like step up my own game. There's people who rode across the Pacific Ocean with Parkinson's. And we've had people do and Iron Man. We have a gentleman who's finishing a hundred marathon in a hundred days. And you know, you sit there and you makes you wonder what you're really capable of if you, you know, when push comes to shove. it is remarkable and you can walk away with a a sense of blessing and thankfulness for
the exposure that this disease has given us to the people that we've come to call friends and colleagues. it's really kind of unique. I often speak of the law of compensation, which basically can't take anything away from you without giving you something of equal value. And so as much as Parkinson seemingly is taking away from you, it takes very little considering the value of compassion empathy and joy and
gratefulness and gratitude that it gives you for the small blessings that, know, you can find if you have the right mindset.
Ryan Cotton (40:17)
Yeah, that's that's super well said, Eric. We're sitting here on
June 16th of 26, just after the World Parkinson's Congress, which was in Phoenix. So the World Parkinson's Congress is bringing together all the Parkinson's community from around the world. So it's a unique conference where there's people, people with Parkinson's caregivers, family members of people with Parkinson's, clear up to the top researcher in alpha synuclein proteins, right? So this huge breadth of the Parkinson's community, and it's always amazing to
Eric Von Frohlich (40:46)
Right.
Ryan Cotton (40:51)
Me at that event, the juice you get from the people with Parkinson's that share in exactly what you just reflected, right? Like, well, this disease stinks. I'm not glad to have it, but there's this community here, and I'm glad to be part of the community, and I'm glad and active in this community, pushing us all forward to do better things for the community because of the community.
Eric Von Frohlich (41:19)
you're in such a unique position of leadership to have that compassion and that degree of understanding and appreciation for what we go through as in it. really kind of remarkable. So got some follow ups for you. What challenges come from scaling a program and maintaining its mission? So you guys have
had this mission for Rock Steady Boxing. Now, how do you maintain that mission while you scale this incredible global phenomenon?
Ryan Cotton (41:49)
Yeah, that's a that's a great question. and interestingly, in my time of with the organization, the mission has changed. So when I started with the organization, one location in Indianapolis, one gym with boxers, our mission was to serve the people in that gym.
Eric Von Frohlich (42:06)
Right.
Ryan Cotton (42:06)
Now with eight north of 800 locations, our organization's mission is to equip the affiliate owners and the coaches so they can serve their Parkinson's community. So we're serving the Parkinson's community through our affiliate coaches and owners. So just in changing that mission, it really changed how I, as leadership and the board, looks at our strategic plan and how do we
equip those coaches and affiliate owners to serve their community. so to me the some of the growing pains we've had, you know, we didn't start training other people in the Rock Steady curriculum until 2013. And between 20
Eric Von Frohlich (42:53)
Wow.
Ryan Cotton (42:55)
Between 2013 and 2019, we went from one location to at its maximum, and I say we estimate because I'll tell you why here in minute. We estimate there was 915 to 950 locations. And we estimate that because we didn't have any stinking infrastructure.
Eric Von Frohlich (43:15)
Wow.
Ryan Cotton (43:16)
We grew so fast, you know, we were keeping track of ⁓ and this was before this was when I was on the board, but the you know, the organization and staff, we were keeping track of affiliates on spreadsheets. We didn't have any software infrastructure to kind of corral and keep track of all these things.
Eric Von Frohlich (43:34)
Amazing.
Ryan Cotton (43:35)
when I came into my position chief scientific officer in 2020 was COVID. So we had to pivot and deliver all of our training online. And then when I came in as chief executive officer, one of my first goals was to get some infrastructure in place. So now we can say exactly how many affiliates we have, where they are. I think as we scale and
continue to increase our reach with our mission. So I think our mission will stay the same. Equip our affiliates and coaches. The reach will now expand. We have of our 847 affiliates
Eric Von Frohlich (44:06)
Mm-hmm.
Ryan Cotton (44:17)
790 of them are North America, and the other ones have come to us through passionate individuals, right? Someone in Norway who wants to learn the program comes to the States, they learn the program and then they take it back to Norway. we need to expand our reach is how do we purposefully grow outside North America?
How do we grow and support new affiliates, new coaches across UK and Europe, across South America, across Africa, across the Far East? We have affiliates in those locations now. Like I said, they were led by individuals, but we need
Access and boots on the ground in those areas where we can really purposefully grow there because Parkinson's doesn't discriminate, right? It's it's at the same or close to the same rates everywhere in the industrialized world that we need to have our reach into those areas because they're so underserved with exercise.
Eric Von Frohlich (45:12)
Yeah.
Yeah, it's amazing that that's still the case, right? You think that that that message would have gotten out there already in bed and taken care of. So what's ahead for Rock Steady Boxing?
Ryan Cotton (45:34)
Yeah.
hopefully we've got infrastructure in place now. what's ahead? We're always looking at
Digital space and digital delivery, right? If if someone can't make it to a gym, how can we get them classes digitally through streaming or on-demand services? and the you know, the other big thing is how do we reach those areas that aren't served? So that could look a bunch of different ways. We could collaborate with organizations that are already there, we could establish
established
kind of mirror organizations to ours in those areas. So really that growth is principal consideration of what we're looking at going forward.
Eric Von Frohlich (46:22)
super interesting coming off the heels of the World Conference and all the things that you must have been exposed to. What were your key takeaways the conference?
Ryan Cotton (46:32)
so conference happens every three years on a regular schedule. it got interrupted by COVID a little but the last one was in Barcelona a couple years ago and the exercisers that were there were
kind of off to the side. And frankly, we we felt our importance was was minimized in the room when there's, you know, big pharmaceutical companies and big time scientists in the room. at this conference in particular, all of us joined together in the vendor hall.
We all represented exercise together because we all agree we have our own recipe for exercise. It all follows, it all has some of the same ingredients, but the mechanism of delivery is a little different. We talked about the rowing or the cycling or whatever. And so we've joined together in promoting exercise as a whole for Parkinson disease. And I think that's transformational in the community where we're not.
Eric Von Frohlich (47:18)
Right.
Ryan Cotton (47:35)
We have an abundance theory, right? There's far too many people with Parkinson's without access to exercise. And us squabbling over scraps isn't going to get done what needs to be done. The problem's way too big for that. So we all work together. And we hope that is an example for all the other
Eric Von Frohlich (47:41)
Right.
Ryan Cotton (47:53)
professionals around the Parkinson's community table that so much more can be done working together working independently in our silos, frankly kind of against one another.
Eric Von Frohlich (48:06)
Right. It it is kind of amazing how we cannibalize our own message. Instead of, you know, as you said, there's so many there's so many needy people and so many desperate people. And the most powerful drug that we have to date is exercise. It's kinda like we have the golden ticket and we just have to get it to everyone's so that they can come join us in our little adventure.
Ryan Cotton (48:11)
Right.
Yeah, as i in this last year I as
Part of Rocks City Boxing and David Leventhal's part of Dance for Parkinson Disease and Cynthia Fox is the part of LSVT Global. Jenna Dytal, who's part of Davis Finney Foundation and Pedaling for Parkinson's, and Andrea Merriman, who's part of PMD Alliance. All of us got together and we presented on the importance of exercise for the Parkinson's community at a physician's conference. and we we weren't selling this program.
or that program, we were selling all these programs are available to people with Parkinson's. And the importance is that they participate in something that is on our menu of offering.
Eric Von Frohlich (49:12)
Well, it sounds like it was a great collaboration.
Ryan Cotton (49:15)
It is a great collaboration and hopefully can be an example to to the other folks out there that boy, rising tide raises all boats, right?
Eric Von Frohlich (49:23)
That that's for sure. I got a short, quick question for you. How do you define resilience?
Ryan Cotton (49:27)
Yep.
resilience you know in in in boxing terms it's taking one on the chin getting knocked down but getting back up to get back in the fight I think in human terms it's continuing one's work even if it's not
Recognized at the time or will be recognized in the future, but it's just the right thing as a means to an end, right? Like staying with something because it's the right thing to do, even if you never get recognition for it. do you know the name Michael Collins?
Eric Von Frohlich (49:58)
Yeah.
I you know the name, but I'm not sure what my reference point is for it.
Ryan Cotton (50:14)
Do you know the name Neil Armstrong and Buzz Aldrin?
Michael Collins was the other astronaut that drove it drove his buddies to the moon, dropped them off, flew around for a while, picked his buddies up and came home. And th resilience is the ability to be the Michael Collins, right? Like
Eric Von Frohlich (50:22)
You didn't walk on the moon.
Yeah.
Ryan Cotton (50:40)
Doing
all the right things, knowing what you're doing is essential, knowing that you're doing the right things and knowing that you're probably not going to get the recognition anyways, but you do the right thing because it's your it's your job, it's your passion, and it in many cases tees someone else up for the success and you're happy for them for their success because you helped them get there even if you didn't get the recognition.
Eric Von Frohlich (51:05)
Well, it's like the story of a the man who plants a tree for the shade that he'll never see.
Ryan Cotton (51:11)
Right. That's right.
Eric Von Frohlich (51:13)
I wanna kind of wrap this all up because we could do this for hours, no doubt, and you have some bad weather coming in, so I just wanted to thank you for joining us today and sharing both your expertise and your passion for helping people live well with Parkinson's.
Ryan Cotton (51:27)
Thanks for having me, Eric. Thanks for being part of the community and part of Rock Steady and we'll keep moving forward. Appreciate it.