Pain is one of the reasons why many people stop exercising. They get demotivated and start gaining weight. Pain should not be a limitation for you to continue exercising. While I am very extreme about pain and I can handle big amounts of pain and continue with my exercise plan with no limits, I know that many people can’t deal with pain. Therefore, I interviewed Nick Perterson, a professional Physical Therapist, who knows a lot about the topic.
Nick is the owner of New Castle Physical Therapy. He is very good at helping people with pain and I think he is a good person to ask about how we can avoid injury and how we can alleviate pain to continue exercising. Let’s listen what he has to teach us about pain:
Sandro, “Welcome to another video here at Custom Body Fitness.Today we have Nick Peterson. He is a physical therapist and owner at New Castle Physical Therapy. How did you start your physical therapy business?
Nick Peterson, “My wife and I have been traveling physical therapists for the last few years. But with Covid, that ended. That is when we decided to create our own business.”
Sandro, “Tell me what made you start a physical therapy business? What was interesting to you?”
Nick Peterson, “My mom is a physical therapist and when I was a kid my mom used to take me to the hospital and I saw people with severed burns and with tons of pain. That is when I thought I wanted to be a physical therapist. I was really into premedication track until college. In my junior year college, I was in a class that was a great class. I got to shadow local doctors and surgeons. I was very interested in what they were doing, but one common thing I can keep seeing is that many of the doctors were rushed with the patients they had. They give them eight to ten minutes. They don’t have time to get to the root of the problem, so their answer was always medication.
And I did not like that because I am a strong believer of the natural ability of the body to heal itself...
I started questioning my career choice and my mom suggested physical therapy. I went to a local physical therapy clinic and started shadowing them and I thought that was cool. I love to understand the body. I love to help people and solve problems.``
Sandro, “You wanted to get people out of their pain. I had three surgeries and two of them were bad. The first doctor was not good enough for the surgeries. When I was in consultation with the first surgeon, I was not happy with his explanation of the problem. The second doctor explained with details what I wanted to hear. Like you said, some doctors don’t have the time.”
Nick Peterson, “Some doctors would want to help, but their hands are kind of tied by the system they are in. They don’t have enough time for patients. In physical therapy, we do have the time to talk to the patients, listen to them, find out their background, find out their personal goals, their fears, and what their expectations are. We do a whole body check up, hips, knee, ankles. If there is a problem, how can we solve this in the long run? And if we can’t, what is the next step? Who should we refer our client to? The goal is to understand and see our client’s body in depth.
Sandro, “Let’s talk about imbalances. What can you tell us about compensation of the body?”
Avoiding an injury...
Nick Peterson, “We have to look at what is happening above and below the joint. For example, if we are talking about the knee, we have to look at the ankle and the hips and also the other side. To give an example, if someone comes with knee pain and they have tied ankles and they do CrossFit, so when they squat, the knee has to move forward a little to stay balanced. But if the ankle does not bend, they start to fall back. So they lean forward and that can put pressure on the lower back and that is how they start to have back problems.
The same goes to the hip. Many people have a pinch in the hips and start to put on more weight when they squat on the opposite side and that becomes a pattern that follows for years.”
Sandro, “Like a car. If you are driving an all wheel drive car, you must use all of the same tires. Otherwise, you can break the transmission because you are putting more pressure on one side of the car. Let’s talk about more common issues, knee, shoulders and back. What usually triggers pain in those areas? “
There are a variety of things that can cause pain...
Nick Peterson, “Those are the top three I see by far. There are a variety of things that can cause pain. I just mentioned one of the problems. If you are compensating in other areas, it can affect what we talked about. However, a big thing I see is really training errors, doing too much or doing too little in an area. Let’s say CrossFit, because I see many CrossFit injuries. CrossFit has a reputation for developing a lot of injuries which is true in some areas and not in others. People who are doing it without getting hurt, they are doing it to the intensity that is appropriate for their body and not go 110%. People who get hurt, they kind of develop habits of ignoring pain or push through pain. Pain doesn't mean that we have a severe injury, but we should pay attention to it.”
Sandro, “Let’s be more specific about the knee. What are some causes that cause knee pain?”
Nick Peterson, “For the knee the top things I see are traumatic injuries of overuse.”
Sandro, “Let’s talk about both.”
Nick Peterson, “Let’s go to traumatic injuries first. If you play sports, a lot of traumatic things happen with landing or contact. Overuse is when you do more than your body can handle. In both cases, your body’s readiness- the strength, mobility and preparedness is probably the biggest factor.
Sandro, “So to avoid these injuries, you need to strengthen your muscles. What can you do if you overuse the knee to alleviate the pain?”
Nick Peterson, “Most people respond either by resting one hundred percent, or they just ignore the pain and push through it. Both are not the ideal response. The answer is some right in the middle. When an injury happens, we want to back down the intensity of how hard and the volume, but we want to keep our body moving. The body heals through movement. Movement is like medicine to our bodies.
Sandro, “Let's talk about the lower back. What can they do to avoid injury and to alleviate pain?”
Nick Peterson, “Lower back pain is the top one. This is another case when there is overload in the tissues of the back. With people who are active, what I see is, hurting their back with more weight they can lift- Squat and Deadlift, they think about what they can do right now without building their body gradually.
For people who are inactive, lifting something heavy that gets a pain cycle started, strain a muscle, injure a disc…”
Sandro, “With a strained muscle or injured disc, would that heal?”
Nick Peterson, “It does, at least to a degree. Sometimes it does not heal one hundred percent. But they had studies where they looked at people with injured discs and things like that. Some of them don’t heal, but some do heal. For people who don’t heal, they recover their function and alleviate pain still.
This is a big conversation with some people. Some people start with a MIR and they would say that shows some injury and they think they are screwed and they need surgery. I won’t go so fast. Surgery is a big deal. You are going to be out for several weeks and months at minimum and thousands of dollars just for the first step. The average cost of a MIR is $2000 in a hospital and $1000 out of it. For that cost you can do physical therapy for many weeks.”
Sandro, “And you don’t know if surgery is going to be effective. You really need to study that.
Some people can handle a lot of pain and other people can’t handle a lot of pain. What do you think about that?”
Nick Peterson, “There are times where you can work through pain and some others where you can’t. There are people who can work in higher levels of pain and still get healed. Where others don’t. The general advice I give to my clients is that if it hurts a little bit and does not get worse, you can continue working. If you start and in each repetition hurts more and more, that is not going to end up good.”
Sandro, “So what you recommend is for them to continue exercising. Pay attention to the pain and workout according to it and don’t stop. Tell me about your exercise routine and tell me about your eating?”
Nick Peterson, “I like variety. I train three times a week, I bike, I run and hike. I eat healthy. I eat fruits and vegetables. I eat healthy meats, fish. I do intermediate fasting. I practice what I think are the 4 pillars of health, exercise, sleep, healthy eating and manage stress.”
Sandro. “What foods do you recommend to people to recover faster?”
Nick Peterson, “If you are recovering from an injury, there are several key things. One is getting a good protein intake. If your body is injured, it needs protein, not only to help recover, but also to start to build those muscles that atrophy and weaken withs injury. You need one gram of protein per pound of body weight. You want to spread the protein during the day.”
Sandro, “What do you do to recover? And what do you do to alleviate pain?”
Nick Peterson, “The most effective recovery things are the most boring but underrated. Sleep is probably our biggest super power. Sleep is your body’s biggest recovery tactic. When you go to bed so many things are happening at night while you are asleep. Your body is repairing your muscles, getting your nervous system to recharge. I focus on getting eight hours in bed right now. I make it a priority. Another thing is that you have to give your body good nutrition and enough.
You can do all the things right, but if you don’t sleep enough and are highly stressed, that puts the body into a fight or flight mode...
That system needs to come down for recovery. So three things, know how to deal with stress, sleep and good nutrition.”
Sandro, “What do you recommend your clients do for recovery?”
Nick Peterson, “I recommend those three we just talked about and exercise.”
Sandro, “Thank you for coming Nick.”
Here is what I learned from this interviewed:
Exercise increases our body's resilience, and its capacity to do things. We need to train our body to be and stay strong to perform the heavy and stressful physical tasks in life and not get injured.
Get enough protein intake to recover. Our body needs protein to build new tissue and strengthen our muscles and ligaments and so on. Eat enough to recover fast. Make sure it is not junk food.
Sleep is your body's biggest recovery tactic. If you want to heal and recover fast, don’t neglect sleeping. Sleeping is when your body is repairing itself.
The body in a state of stress does not recover well. If you want your body to recover fast and you want to avoid injury, learn how to deal with stress. Stress can put a toll on your body.
To stay healthy and without injury, exercise, sleep, eat healthy and manage stress. These are the four pillars of health.
Very useful information to apply in life to stay healthy and without injury. Thank you for continuing to follow us!