Taking An Active Approach To Injury; What To Do For Back Pain & Taking Ownership Of Your Back Health
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Welcome to the Back Pain Solutions Podcast – Taking An Active Approach To Injury; What To Do For Back Pain & Taking Ownership Of Your Back Health
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Introducing Dr Meghan Braun – Taking An Active Approach To Injury; What To Do For Back Pain & Taking Ownership Of Your Back Health
The global research is compelling when we consider the number of cases of obesity, heart disease and other ‘lifestyle’ based diseases. It seems that people are not prepared to take a proactive approach to the management of their health and wellbeing. The incidence of chronic disease is increasing, and healthcare costs are rising as we try to manage the cases of ‘self-inflicted’ illness across the world. Despite suggestions that the younger generation are better informed, and more health conscious, it doesn’t seem that the message is getting through to everyone just yet! According to the World Health Organisation approximately 3.2 million lives are lost each year as a result of insufficient physical activity!
Whilst the figure above is staggering to comprehend it does not tell the full story. Whilst a significant number of people are losing their lives each year as a result of inactivity, what is the overall quality of life across the global population, and what other health issues are occurring as a result of poor lifestyle choices? Unfortunately, in many cases, it is only when individuals experience illness, injury, or pain, that they seek help and even then, they often want a quick solution. Often people expect that medication, or passive care alone, will solve their underlying problem without them having to do anything themselves and lower back pain is just one example of this.
Evidence increasingly demonstrates that the repetitive nature of the lives we lead, inactivity and the resultant deconditioning are impacting back health. Unfortunately, without a proactive approach to preventing back injury, or without taking an active based approach to rehabilitation, the numbers will only rise. In this episode of the back pain solutions podcast we’re joined by Dr Meghan Braun as we discuss the importance of taking ownership of your injury, why the symptom-based approach of traditional medicine is failing, and how there is not enough focus on preventative medicine in todays healthcare environment.
Dr Braun is a board certified and licensed Physical Therapist in the state of Florida over in the US, specializing in sports performance and rehabilitation, injury prevention, return to play, strength and conditioning, and much more!! She’s certified in Manual Therapy (MTC), and is also an Emergency Medical Responder, and Strength and Conditioning Specialist (CSCS) promoting athletic and movement development.
Dr. Braun’s philosophy is focused on applying treatment beyond the symptoms; by identifying the root cause of pain or discomfort, correcting movement discrepancies, and providing appropriate treatment plans with emphasis on patient education to Restore, Develop, and Strengthen functional mobility.
Her newest venture is partnering with The Lax Box which is Jacksonville’s premier indoor/outdoor lacrosse training facility; fully equipped with areas for strength and conditioning, athletic training, physical therapy, and specific lacrosse skills workshops, clinics, and more! With a keen interest in lacrosse and basketball she continues her passion of playing and coaching sports within the North Florida area.
Some of the things you’ll discover…
- How the approach to medicine is shifting with a focus on preventative care.
- Why a surgical repair for injury requires rehabilitation to be effective and in many cases can improve outcomes if started in advance.
- Surgery is always an option but it shouldn’t be the default approach because you can’t go back!
- Why your therapist should focus on educating you about your injury and not just focusing on providing intervention.
- There is a pattern of patients seeking care from numerous practitioners when movement based intervention is not considered.
- Why you should not underestimate the education provided by a good therapist and how it can empower you in the long term.
- A good therapist will recognise their limitations and draw on their network to help you reach your goals.
- Why you should be careful when partaking in crossfit classes as a result of the injury rates being experienced globally. Be sure that you’re getting the correct advice from a trained professional and not just focussed on completely a WOD quickly!
- Why traditional medicine alone is not a solution for low back pain and other musculoskeletal injuries
Show Highlights
Surgery is not always the solution, certainly not without good rehabilitation. Don’t be fooled into thinking that surgery will solve all of your problems, you still have to take ownership of your rehabilitation if it is to be successful. Too often people want a quick result, without having to do anything themselves, but you can’t afford to take this approach in life, and certainly not with your health. The surgical route is a one way street, you can’t go back, so consider getting the right advice, and putting the effort in, BEFORE you make that decision. At least that way you give yourself more options if they’re needed.
Interview Transcription for …..
Intro 0:00
When we’re young, we move with freedom and confidence with a great resilience to injury. But somewhere along the line we develop poor habits and become more vulnerable to back pain. Back Pain solutions features evidence based and practical advice to help you take back control of your health and get back to the activities you love. This is your guide to better back health through movement. So join us as we demystify some of the commonly held beliefs about back pain and build your confidence to a stronger back the smart way.
Ben James 0:28
Okay, welcome back to the back pain solutions podcast Everybody with me Ben James As always, and my co host Jacob stain today. We welcome our special guest, Dr. Megan Braun from the US and we’re talking taking ownership of your pain and injury and taking an active approach to recovery. Dr. Braun is a board certified and licensed physical therapist in the state of Florida over in the US specializing in sports performance and rehabilitation, injury prevention returned to play strengthen conditioning and so much more certified in manual therapy and he’s also an emergency medical responder and strength and conditioning specialist promoting athletic movement development. Dr. Braun’s philosophy is focused on applying treatment beyond the symptoms by identifying the root cause of pain or discomfort, correcting movement discrepancies and providing appropriate treatment plans with an emphasis on patient education to restore, refreshing to hear, developing strength and functional mobility. The newest venture is partnering with the lacs box which is Jacksonville’s premier indoor outdoor lacrosse training facility, fully equipped with areas for strength and conditioning, athletic training, physical therapy and specific lacrosse skills workshops, clinics, and more with a keen interest in lacrosse and basketball. She focuses a passion on playing and coaching sports still within the North Florida area. So does movement and sport form key elements of our approach to rehabilitation? Are people doing enough to help themselves isn’t and Is that enough? Focus on preventative medicine in today’s healthcare environment. Well, just some of the things we’ll discuss on today’s episode of the back pain solutions podcast as we welcome to the show, Dr. Braun, Dr. Braun. Welcome to the show.
Dr Meghan Braun 2:09
Hey, guys, thank you for having me.
Ben James 2:12
You’re welcome. Thanks for being on. And I guess, as always with the other guests a good place to start is just to get a, I guess a bit of insight into where where things began for you was, was sports therapy always something you were wanting to do from a small young age? Or is that your sporting endeavors and response to injury or help or injury that kind of set you on this path? I guess?
Dr Meghan Braun 2:35
Yeah. There’s been a few different times in my life that I decided to go this route. You know, I’ve always played sports. Pretty much since third grade. I played basketball, soccer, softball, volleyball, you know, every single sport you could possibly play. I did it. I grew up in the military. My dad was in the Air Force. So we moved around quite a bit. We actually were stationed in England for for a time and Lakenheath. So I got a little connection over there. But of course was, you know, a way that I could actually engage with a new school I went to, to two elementary schools or three elementary schools, two middle schools and two high schools. So I definitely had to figure that out quick, but I knew that I wanted to do something as far as helping athletes, you know, be able to move and not just athletes, but people in general, be able to move without medications without injections without surgeries. My brother, he went through a really tough time he was a wrestler and he tore up his rotator cuff. He had surgery, but he never really had that drive to get back into into wrestling again. And as a PT, I really think it’s important that we connect everything, you know, mental, emotional and physical to get our athletes back to where they want to be.
Ben James 3:52
Yeah, absolutely. I think that that kind of holistic approach seems to be gaining more, I guess it’s certainly come into more Most of the front of the mind for everybody now is the internet. And maybe the Internet has made a difference as people are doing a lot more research themselves and taking more of a holistic view because this is one of the things that we often focus on. And for me over here in in the UK, I think that when we when we’re younger and we grow up, we get free health care and people don’t take a proactive approach to their health, maybe that’s because we’re going to free doctor free health care, which is which is phenomenal for us, particularly in light of this covert situation. But does it make people a little bit, shall we say naive when it comes to preventative medicine and approach and certainly the kind of aftercare after surgery and things. You know, when I’ve had a knee reconstruction for ACL injury, the surgeon was very good and said, Look, you know, I’ve done my bit pretty straightforward, but now it’s all about the rehab and the kind of rehabilitative care if you’re going to really get back to sport. So do you think that there’s a similar change in the US is there Still reluctance or naivety, do you think amongst patients about what they need to do for their health?
Dr Meghan Braun 5:07
I think to some degree there is, there are patients that are very aware, especially as an athlete, you know, if you’ve had other injuries, you tend to understand the process. Even if it was a small injury, people that haven’t had a lot of injuries or maybe haven’t had a surgery or anything like that before. They don’t really know what to expect after the fact. And so, you know, sometimes you’ll get surgeons that don’t even recommend rehab after which to me is is crazy. Yeah, exactly. Because at that point, you know, you’re trying to help someone and you know, your surgery doesn’t do very much if you don’t have the rehab after like, you could be the best surgeon in the world. But if you’re not doing the things afterwards, to help strengthen that joint again, or help that person move again. You know what The point so.
Ben James 6:01
Yeah.
Jacob Steyn 6:02
Yeah. What I quite often see is, you know, if you do rehab before the surgery, but often you don’t even need the surgery. And I think that’s something that we haven’t even touched on many places, especially in the Netherlands. Yeah. You probably know, I mean, with a lot of my patients, what I see is that if I would have left them, probably they would have ended up in surgery. And I mean, we’ve had paid we’ve all probably had patients that after the surgery, you can do a lot of rehab and they get better, but not as good because the surgery isn’t always the answer.
Dr Meghan Braun 6:36
Mm hmm. Yeah. And that’s the same thing here. You know, I, that’s one of my things that I really try and get people before that surgery. You know, surgery is always going to be there. You can always go get surgery, you know, there’s no there’s not a lack of surgeons that want to operate for sure. But you can’t go the other direction. You know, once you have surgery, you can’t try and try All these different, you know, approaches. So I always tell my patients Look, if we do therapy and you are compliant, meaning you’re doing your exercises, not just when you’re here with me in the gym, you’re doing your part, we can really get this, you know, back to where you want to get it. And then I also talked to people very much so about the actual, I guess, timeline of surgery, right? So it’s not just you get surgery, and then you’re out for a little bit. There’s a lot that goes after every surgery, whether it’s, you know, something smaller, like the laminectomy is that they do now or if it’s an ACL surgery or hip replacement, there’s a lot of time that it takes afterwards to just quote, feel normal again. So I think people don’t take that into account. You know, they just want that quick fix. But surgery is not a quick fix by any means.
Jacob Steyn 7:53
Yeah, it’s very seldom that somebody comes out of the surgery and go, Oh, well, I’m I’m fixed. I’m good,
Dr Meghan Braun 7:59
Right?
Ben James 8:01
And yet that’s, that’s the thought process there. I mean, I’ve I mean in a number of groups on Facebook kind of sciatica and low back pain support and things just just observing some of these comments and some of the messages out there and generally the the approaches How quickly can I get surgery? How can I get help for surgery? And that’s what this group seems to be very much focused on and that doesn’t seem to be this thought process of what’s actually caused this in the first place and and is it incorrect movement or any of that, you know, there seems to be this there’s a lack of understanding of these the lives that we lead lead to a lot of these problems and there’s this kind of approach that I want it cut out more the classic for for chiropractor is can you adjust my my herniated disc back in, you know, and the reality is, I will even in my head, could you go back to doing what you’re normally doing every day, then it’s just gonna happen again and again. Yeah. So I think this One of the key drivers for us with the with the podcasts and things is to is the education. Because that’s what I realized is my role. One of the biggest things is educating and now it’s trying to is trying to get out there and get the message out there to catch these people before they have an issue. And that’s the challenge. Is there anything that you’re doing to to try and do that? Or is it kind of word of mouth or obviously, jumping on podcasts like this, your your view is similar to let’s try and get people before they get an injury, or certainly before they go down the surgical route just to see, well give me a chance. Let’s see if we can avoid that surgery because actually, the pain afterwards is is you know, is is still pretty significant or can be.
Dr Meghan Braun 9:39
Yeah, that’s something that I definitely you know, I think in the healthcare profession, we need to be educating more. You know, I’ve worked in hospital settings, outpatient and inpatient, skilled nursing pediatrics, I’ve pretty much done it all and that’s one of the huge issues is just the education you know, when you take the time sit down and talk to patients could be 510 15 minutes and you just let them know like, this is what’s going on. This is what I can do for you before going into surgery or before taking that injection or before taking this medication. And these are the side effects of doing the surgery, medication injections. You know, a lot of people make more informed decisions, but again, it’s just that education.
Ben James 10:24
Yeah. And how do you find patients responding generally? Would you say there’s a percentage split of those people? Obviously, if you’re dealing with athletes, then the mentality seems to be different. They kind of get it. But with with some of the general public, do you find there’s a split and percentage of patients that just come in and just expect that passive treatment will will help and how do you kind of work to, to kind of get them more compliant because certainly when I was younger, and someone said, I’ve just never done exercise, I don’t, I don’t do exercise. I kind of didn’t have the maturity or the confidence maybe to say, this is how it is, you know, you’ve got to do it. If you’re not prepared to do it, then this is how it’s going to be. Maybe you should see somebody else or maybe, you know, you’re just gonna have to accept that it’s going to be a recurring problem. Do you do find a percentage split? Do you do you do anything specifically to try and get people compliant? Or is it just say how it is?
Dr Meghan Braun 11:16
Well, that’s all you know, the beauty of my clinic is we are all cash based. So I’m not necessarily you know, sure how it is over the pond, but here in Florida anyways, we get 30 days of direct access, meaning someone you know, with back pain or whatever it is, could just come in, they don’t have to have a referral from a physician. And I can see them for 30 days. And again, I don’t take insurance so we kind of cut that out as well where the insurance dictates how often they can come how many visits they get that kind of thing. So when people come and see me here, especially, they usually have gone through the other routes already seen other pts that you know, they weren’t getting great care at seeing chiropractors seeing Physicians getting injections, things of that nature. So by the time they get to me, you know, read my reviews and they’re like, you’ve gone. You know, you’ve seen a lot of people with issues like I have and gone through, you know, kind of the same route. That by that point, they’re mostly bought in already without me having to do a whole lot. But after the first you know, few sessions and them actually seeing those results of not only in here with me, but then doing what they need to be doing, then they’re really bought in at that point.
Jacob Steyn 12:30
Can I ask to do people in the States or at least where you are do they generally first go to chiropractors and then after that, maybe they consider going to a physio or is it the other way around? Or is it kind of mixed? Because over here in the Netherlands, chiropractic is quite small. So people, there’s a big physiotherapist, I think we have the most physiotherapist for the amount of people in any country in the world. So which means that you know, there’s there’s a big Exposure to physiotherapy, which means that people would go there first and then maybe they’ve been to a couple of years and then maybe they would try the chiropractor? Is it? Is it the other way around where you are or, or not really?
Dr Meghan Braun 13:14
It kind of depends. If it’s spine related and most people tend to go to a chiropractor here. If it’s extremity related, it’s kind of a toss up between do they go see their ortho, like the orthopedic surgeon first or do they come to PT? So it’s just it depends really,
Jacob Steyn 13:35
Because over here, it’s a it’s generally well I usually surprise people because they come to me and they expect this traditional chiropractor. That’s gonna, I don’t know crack them 100 times in a week or something and then I you know, the first time I don’t even I don’t even know manipulate them. I just give them exercises or I’m using with a working with a posture or resetting muscle groups to stable As a joint or something like that, exercise the sun, I quite often have to use all of them. I had a guy recently Dutch guy who was living in the Netherlands, sorry, living in the states for 10 years. And he came back with the whole COVID thing. And I did the, you know, I did the investigation, and we talked about its problem. And then I gave them exercises, and, you know, try to educate them about what we got to do from a functional approach. And then I actually did give him a quick manipulation. He was like, well, is that only gonna do and I’m like, we’ve been busy for an hour, man. Yeah, I’ve given you a little manipulation because something needs to come on stock, but really, that’s not going to do anything for you compared to the posture training and the exercises and you know, and then the sort of and the education I’m trying to give you with which we’re going to use to go somewhere with your problem.
Ben James 15:04
Yeah, people don’t tend to value that that kind of educational piece as part of the, the treatment and the investment. Which Yeah.
Dr Meghan Braun 15:11
The whole experience, right? Yeah. And you know, in my, my network, I do have chiropractors that are great, because they actually know what I can do and I know what they can do. And so we do a lot of cross referral stuff. But you don’t get that very often here in the States. You don’t get very many people that want to admit their limits, I guess, and kind of bring in other health care professionals to, you know, like we talked about approach things holistically. That’s that’s a lot of what I do. You know, I bring in nutritionists, I bring in social workers, I bring in chiropractor, it just depends on what that person needs. I know that I can’t be everything for everyone all the time. So.
Ben James 15:54
Yeah, exactly. I think just a nutritional point because this is something we’ve we’ve discussed and touched on just how You know how influential Latin can also be. And again, you know, people just sometimes don’t want to hear it or are just surprised. And again, it’s back to that educational piece of Look, guys, you know, this could have a huge influence on chronic inflammation, long term pain, all these things. So it’s, it’s interesting, but I, it’s a, it’s a classic question we get over here. I did a talk recently. And the question was, well, what’s the difference between a physio and osteopathic chiropractor? Who should I see, you know, and the response he was given in terms of who should you see is you should see the person that gives you the advice and an exercise based and active based approach to recovery specific to the back health at this point. Because for me, if all you’re getting is that passive treatment, and that that whack crack, as I like to call it, then you just get in a disservice because you’re going to go back to the day job and you’re going to go back to these things and if you’re not taught about movement, and and how important that function is, then then how you’re going to get better, you know, and it’s again back to that educational piece, but it’s It’s funny how there seems to be a them and us kind of approach. And certainly, I think there are definitely practices therapists that are very protective. And there seems to be a continuum. Some are very much. Yeah, it’s got it’s all about the adjustment, and some are kind of far more functional. And then there’s people in between, but there are certainly groups that it’s a bit cult, like, shall we say, what’s it like in the US? Is it is it similar? Do you think it’s, it sounds like it’s rare to have that kind of collaborative approach, which is a shame because the the result and the the aim for us all is the same is to get people back to doing the things they love. You know.
Dr Meghan Braun 17:38
Yeah, there definitely is that kind of divide, you know, but like you said, I think it kind of goes on that spectrum. You know, same thing in the PT world, you have people that got their license, and they they’re fine. Just being in you know, one skilled nursing facility and just walking people around all day long and you know, that they’re, you know, they’re bread and butter, I guess. But, you know, for me, that’s that’s not what I enjoy. I like the challenge of PT, I like to be able to get people moving as best they can. And again, make sure that they understand why they’re there, what it is that they can do on their own. And, you know, if something like this pops up, you know, later on in their life, they kind of have those tools, you know, to be able to approach it. And then if that doesn’t work, then they know that they can come back and see me again.
Ben James 18:28
Yeah, and I was interested just on the point that you you made about the cash based practice just kind of jumping back is that purely because of the type of patient and client that you’re looking to get you just know that if their cost base, then they’re going to be more kind of bought into what you’re doing and telling them rather than kind of, you see often these are free free consultation or whatever it might be an often that I say often sometimes that leads to poor quality patients, maybe is that is that a specific approach for you that you went down that route?
Dr Meghan Braun 19:02
Yeah, that’s part of it. Um, I also didn’t want to have my treatments dictated by insurance or people that have no idea what, what people need, medically wise. And so that’s a huge part. But yeah, definitely people are more bought in and they’re more apt to do what they need to do when they’re personally invested. And, you know, money and time are big personal investments.
Ben James 19:24
Yeah, sure. One question that we I was interested to ask is from a back pain perspective. Often, you said that patients or clients often go down that kind of Cairo route first. Do you generally find the ones that come to you or those that that haven’t been given that exercise or functional advice and approach? Is it fair to say?
Dr Meghan Braun 19:47
Yeah, usually I’m the chiropractors that I work with don’t necessarily do the strength training or the movement afterwards. Okay. But and then, you know, There are those patients that have gone to chiropractors. And here in the US, I’m not sure what it’s like over there. But in the US, chiropractors can say that they do rehab or therapy because our codes are not specific to just physical therapists. So anyone can use them for billing purposes. And they don’t necessarily have to have a PT degree, which, in my mind is crazy. And you know, like with the American Physical Therapy Association, they’re trying to change those things. But it also puts, I feel like patients at a very big disservice, because now you’re going to a chiropractor for an adjustment. And then you’re getting told these exercises by, you know, like a medical assistant that, you know, may or may not have a certification in something, but it’s not very, you know, movement based and they’re just kind of giving you broad exercises. And then people kind of leave with that feeling of like, Well, I’m not getting better. It’s like, Yeah, because nothing that they’re doing is specific for you and you you’re not really doing what you need to be doing. So.
Jacob Steyn 21:02
Yeah, yeah, we have we have something similar over here where a lot of chiropractors will have forms or A4 papers ready with a sketch and an exercise and I’ll just kind of hand it out and say do do this exercise, you know, and for their adjustments and short appointment and then they get a paper with an exercise and, you know, they’ll usually be a stretching, stretch the neck like this or that, you know, or stretch a performance of your glutes sitting putting your leg up. And that’s, you know, that’s just this is so poor in terms of being specific to the problem and usually there’s been no investigation to try and figure out what they really needed. It’s like it’s a it’s a big the service that people get and people don’t know better. So they think they’re getting exercises. And quite often where the people are coming from any therapist before they come to me because usually, I’m also Being seeing people that, you know, the, at the end, they’ve been everywhere. Yeah. And then, you know, I asked them because they usually get exercise and I’ll be like, what do you what did you get? And it’s usually some kind of stretch or some kind of mobilization and nine out of 10 times all they need really is some kind of stabilization. There’s almost for some strange reason over here in the Netherlands, there’s never you never get a stabilization exercise. And like, I had a lady girl, she’s early 20s. And she had the shoulder issue for nearly 10 years, you know, a long time and she went to neurologists, orthopedic surgeons, too many people she went to even went to a shoulder clinic, which I didn’t even I didn’t know such a thing exists in the Netherlands. And they told her you have some kind of instability, but because you have full range of motion, we can’t help you. And yeah, we did. We did. Yeah, we did simple basic stabilization exercises. I mean, within two or three weeks, she had some neuropathic pain, you know, it’s been there for a while. So it just, it was easily, easily triggered. But after a couple of weeks, she was already having like 50% reduction, you know, it still come back with specific movements that would trigger it, but she’s not completely pain free. And I just, I had to laugh with, you know, a pain, a shoulder clinic, that that tells you, you’ve got some sort of instability, but because you’ve got full range of motion, we can help you. I’m like, What do you guys do? What do you what do you what do you do over there? Like, do you walk into your full range of motion? Okay, that’s good. Bye, bye.
Dr Meghan Braun 23:49
Yeah.
Ben James 23:51
Wow. Wow. I mean, that. And again, it sounds like, you know, to some degree, and I think this is the thing, it’s like almost a commercially driven thing that some Yeah, we do exercises as well just because it ticks the box and it makes them sound a little bit more specialist than than they are. And again, that’s the sad reality of it. It’s it’s kind of commercially driven rather than patient centric, and what are the outcomes in there? You know, what are we really trying to achieve? It’s that long game of we’ll do it, do it right, do it well, and the payoff will come rather than let’s just get as much out of these people as we can. As soon as possible. You know, I think that’s, that’s that’s the the shame and disappointment you see out there a lot of times so. So how long have you been based? If you always been based in Florida, the lax box is that is that kind of just out of a passion just to expand the practice or out of interest? Where where’s that, that come from? Most recently? How long’s that been on the on the radar?
Dr Meghan Braun 24:48
Yeah, um, so lax box we’ve been open for? I think it’d be three years in December. Um, yes. So body mechanics started first. You know, I like I said, I worked at a bunch Different places and figured out that I don’t like working for other people sometimes, you know, or at least do a little bit differently. And sometimes, you know, with those big big clinics, you can’t necessarily do the things that you want to do because again, of productivity and trying to bring in as many people as possible and you know, kind of turning. But that’s, you know, that’s not how I wanted to do things. And that’s not what I wanted my name to be. So started my own clinic in this will be five years coming up in October, actually, so excited about that. And then the lockbox is just kind of been a brainchild of myself and the other co founder, and we both played lacrosse in college. You know, I didn’t actually start until college. So that’s kind of interesting story too. And we still play internationally. Actually, in the summer we go overseas, we’ve played in Amsterdam, we’ve played in Prague, we’ve played in Europe. So, you know, we’re just trying to grow lacrosse because it’s a great sport. You know, it’s kind of everything combined. And there’s great opportunities in it for kids to get scholarships to play in college. And so that’s that’s kind of what we do here.
Ben James 26:15
So is that more of a kind of performance based than it is a rehab based thing?
Dr Meghan Braun 26:22
So I’m a I’m a strength and conditioning specialist as well. So I do a lot with younger athletes to make sure that they aren’t getting injured. So it’s kind of it’s kind of both, you know, like injury prevention, strength and conditioning.
Ben James 26:37
Yeah. Yeah, I think it’s, it’s interesting that it’s almost a different angle to that preventative approach. Because we often say we’ve discussed before that there are some pts out there personal trainers, actually not physical therapists over here in the UK, in Holland, personal trainers that actually, you know, a far, far better knowledge than some of the chiropractors and others out there. And in terms of that prevention, but I think, you know, we see a lot of CrossFit gyms and a lot of injuries there. And there definitely seems to be that gap for me in terms of that preventative functional based gym setting, versus the traditional gym with machines where you can just pay a membership and off you go do you thing or, or the kind of CrossFit where Jacob, you’ll be able to input on this where there’s this input from someone like Jacob which is, which is great from a movement point of view, but there seems to be a lot of injuries coming from from CrossFit boxes and things. Do you see a lot of CrossFit over there? Do you see a lot of injuries come from from CrossFit or in the US?
Dr Meghan Braun 27:44
Yeah, that was actually where I opened up. One of my first clinics was inside a CrossFit gym. And we had a good relationship to start, but you know, I think they also realized that to keep people in the gym, they needed to do more like injury prevention or out least you know the stability type of exercises, and they weren’t sending people to me when they should have. And so more people were getting injured and then people were dropping out of their gym. And so it turned, you know, it started off really well and then didn’t end as great as we both had hoped. So that’s kind of when I went on my own way and was like, Alright, this is this is how it’s gonna go.
Ben James 28:21
Plenty of patients as a result, but, but not the right philosophy for you. And, Jacob you guys have a really kind of strict onboarding approach now, don’t you?
Jacob Steyn 28:32
Yeah. I suppose I’m very fortunate with the, how we work as a team, the two owners of the CrossFit, they, they’re good friends of mine and so, we, you know, I feel like they they respect what I do and they respect my opinion and when I they send me people and when when we have this agreement that if somebody is not able to continue at the CrossFit, then we will stop there. I have to think in English now. No, there we go, there we go, then we agreed that they would stop their membership. And because that’s quite often a worry because you know, over here you you are fixed, you have a fixed membership so it will continue when you’re injured. But I’ve looked at them and I’ve seen Okay, these, this person is unable to keep lifting or not do CrossFit at all. So then we’ll put they’ll keep paying for their membership, but they’ll get back later. So it’s kind of on hold, but they’ll keep because usually you have an option of a month membership or six months or a year and you get a little bit of discount for the longer your membership is. And so, I’m very grateful that they’re there really, because they understand that usually these people you know, they were also not a very performance driven CrossFit were more hipster Crossfit so, we, you know, we get a lot of young urban professionals and they like to come once or twice, you know, we don’t have that bigger group that comes four or five times a week. And so the idea is to, to make sure that they, if they’re getting injured, which they quite often do, because there are a lot of office goers and you know, your most physical people that they get back to functioning well and stay in the gym. And so I’m very fortunate to have that relationship with these guys. And you know, and so I’m, I actually have a treatment room in the gym as well, like what you’ve had, but I’m not there very often I have my other location. And, but you know, then COVID came, and everything else so we need to see how that will go afterwards.
Dr Meghan Braun 30:50
Yeah, and another thing that I try and do too is, is keep people doing what they want to be doing, you know, especially athletes or active people, you Even with their kids, just finding different ways that they can do those things versus saying, okay, you can’t do anything. Because when people get told they can’t do anything, then you know, it’s just this whole cycle and more pain, more issues. So.
Jacob Steyn 31:14
And someone told me once this, I’ll never forget this if you if your outcome based and not income based in terms of getting people better, you know, going for the outcome going for a good outcome, then the income just generates or takes care of itself. And that’s what I’ve, you know, I think in the beginning of my career, I myself had a bit of trouble believing that because I’ve got a I gotta, I gotta have a full agenda, otherwise I’m not gonna earn any money. But what I what I see now is really the more people you get better, yeah, next week, they turn up with both their cousins and aunts and just, you’re just like, whoa, hold on. I don’t have any. I don’t have any space!
Ben James 31:57
Thats the message for the young professionals and the up and coming PT, chiros and others that, like you say be outcome based, and then the long term results will be better both for the patient and financially anyway. So you mentioned the kind of a little bit there on the touching on there, trying to get people keep people doing what they what they love and want to do, because there’s obviously psychological, mental influences to pain and injury and things. You’ve got a psychology degree, is that right? Is that Do you find that helps with your kind of patient management in any way? Or is that? Is that beneficial to some degree? Do you find?
Dr Meghan Braun 32:35
Yeah, yeah, definitely. So I have my bachelor’s in psychology. And currently, I have a program called the raise your game program, which kind of encompasses physical, mental, nutritional and goal setting. So it’s that whole you know, like, we talked about that whole holistic aspect of things. But what I’ve been finding especially with, not just my athletes, but people in general is sometimes there’s So blocked by something, whether it was, you know, a past injury or, you know, they’re just really afraid of doing something or they’re already sabotaging themselves from, you know, getting better, but the body really, I mean, I think that the body can heal itself in the right environment, you know, and then, yeah, the mind is, is part of our body. And if we’re not, you know, treating our mind, right, if we’re not giving our body the right nutrition, if we’re not setting ourselves up for success, then it’s really hard to get back from an injury or it’s really hard to not constantly sustain that same injury, you know, and I’m sure what you guys see sometimes too, is people having the same injuries like over and over and over. And when it comes to that point, if they’re having the same injuries, you know, constantly then we have to kind of approach it a little bit different because now maybe it’s not just physiological, you know, maybe there’s some emotional component behind it. Maybe there’s some nutritional or sleep or water or whatever it is. So I think taking, you know, kind of taking a step back and zooming out a little bit is very helpful.
Ben James 34:06
Yeah, and I think, like you say, is recognizing your own limitations, but looking at it, looking at it, you know, from a far bigger lens, I guess, than just symptom based, you know, looking at it holistically, looking at the nutrition, the hydration, the mental health and all of those things, and then having a network of people that you can draw upon to support that and not kind of trying to be a hero and trying to believe you can do it all which, which is a great result. But I think that’s, yeah, that’s a that’s a really interesting point. I think, the more information I’ve seen out there now, there’s a lot of kind of paleo or hunter gatherer kind of diet approaches. There’s a lot of all these different things that are kind of coming to the fore now in terms of longer term health and a more proactive approach. In general, it will be interesting to see what the kind of paradigm shift is in in terms of healthcare because it always surprises me. It may or may be different in the US, but I’m not aware of any medical program over here in the UK that has any key or certainly in depth focus on nutrition, which is quite frightening when we know how hugely important that is for our overall health to not have that as an element of traditional or, as we say, Western medicine seems to be phenomenal, phenomenal shortcoming for us. And I think, again, you know, Jacob, you’d say the same in Holland. And I’m guessing it’s the same in the US, you know, that I think there’s got to be a different approach over the longer term in terms of how the traditional medical model is, is is focused and is strong because it for me, it’s the antibiotics and things were a huge discovery and hugely beneficial back in the day and saving lives. But it almost seems like that success led down this one path that is very much symptom based, and I think that that for me is problem so it is interest and it makes it more interesting as well to to educate those patients and to bring in other people that really can help them not just with the pain that they may be suffering with their knee but just in terms of their overall health. And I think it’s it’s a real interesting in area it’ll be interesting to see where where things develop but I’m guessing that it is the same over in the US you’re starting to see changes but the medical model as a whole is pretty symptom based Is it fair to say?
Dr Meghan Braun 36:29
Yeah, there’s there’s definitely erm I guess a path with that with symptom based there is starting to become a little bit more you know, like osteopath here are a little bit more holistic. And then you do have some holistic, you know, pediatricians to that I’ve worked with. So, you know, like I said, I kind of am drawn to those, those people in the medical field, that feel the same way that I do and realize, you know, we have to, you know, it takes a village type of thing. Yeah, right. There’s still going to be those those people that think that their thing is the the, you know, save all so it is what it is?
Jacob Steyn 37:11
If I might ask how do you do work with nutrition with your clients or your patients and how do you approach it?
Dr Meghan Braun 37:19
Yeah, so I actually brought on a registered dietician. So basically what I do kind of like in the intake of the raise your game is I have a questionnaire and it’s based off of how you feel about yourself in these categories. So like for physical, for example, it’s a scale from one to five and it says, I, you know, I’m happy with my body or I like the way that I physically look, things of that nature. Same thing with mental nutritional and goal setting and then based off of what people self report, that’s how we kind of form their program based on what they need. So you know, with nutrition, sometimes, just having conversation, you know, I have some athletes that they’ve had body image issues, you know, they want to be strong, they want to be, you know, fast on the field, but they don’t want to look a certain way in jeans, when they’re going out with their friends or in a dress or you know, something of that nature. It’s a very, you know, very two sides of the same coin. And, and it’s hard, especially young female athletes, you know, it’s very hard for them to realize, like, I need to take in this nutrition to be strong, but I also want to look pretty and feminine, and you know, these other things. And so in a registered dietitian, I you know, is great, you know, she obviously knows a lot more than I do. And she can kind of help navigate those waters a little bit more for our patients.
Jacob Steyn 38:47
I like how people will fill in what they how they feel about those different topics on the form because then they, they give you the right to go and work with that because quite often what I find when I work With, with my patients with their nutrition is, you know, you have to be clear not to try and help them where they don’t want to be helped. You know, and you might say, Okay, well this person’s got to lose some weight or they’re chronically fatigued, then we need to do this or, and they’ve got to give you that permission to go there. And you can, sometimes with a conversation, try and figure out whether they’re open for you to explore that a little bit and see how they feel about you know, I mean, generally people we all have very strong belief systems when it comes to our food and our nutrition and you know, if you if you tell a vegetarian, you’re hardcore, vegan or vegetarian, you know, we got to, we got to introduce red meat because your, your iron count is very low, and generally, it’s gonna it’s not gonna happen. So yeah, but I liked that idea, that approach and gives me an idea of maybe what I can do as well.
Dr Meghan Braun 40:00
Yeah, and it’s been very helpful. I think when people take the assessment, it’s, it’s a little bit of eye opening too, because then they’re starting to see like, Oh, yeah, maybe I’m not as nutritionally healthy as I thought, or maybe, you know, my mindset isn’t the greatest all the time. And maybe I do need a little bit of help with that, or they already know that they need a little help with that, but they don’t know how to get that help or what that pathway even looks like to get there.
Jacob Steyn 40:26
Yeah, cuz I and the funny thing is I have generally if I ask people, you know, how’s your nutrition? And I know it’s not a very specific or good question I like they all think they’re eating very healthily. Sitting, sitting across the table chronically fatigued, they’ve just on my intake form filled in like eight or nine out of 10 fatigue or you know, but they they’re eating according to them. They’re eating very healthily. So yeah, you got to, you’ve got to create that, that awareness for them first and then and then and then you’ve got to go with it.
Ben James 41:04
It’s it’s an It is a good point about the the kind of the intake questions and things to open up give you the opportunity and the permission like you say to ask the question, so it’s a great approach. Do you use that approach now for is that is this raised the game for for every kind of client intake? Or is that more specific to the athletic kind of side of things for you?
Dr Meghan Braun 41:21
Um, it can be used for anyone, you know, if you go to raise your game club, you can take a look at it and see everything that’s on there. And you guys feel free to, you know, kind of some of those questions too. But I use it. It’s kind of separate from the PT but still entwined. So everything I do is, you know, everything still has tendrils on each other. And I use, you know, my journals that I’ve written, so restore, develop and strengthen. Those kind of all go along with the same thing, you know, restore talks about mindset, and it talks about tracking, actually trying to see your blind spots or trying to you know, I’m data driven, as I’m sure you guys are to, and that’s just another way for me to, you know, collect that data and for people to visually see because they’re writing something out, you know, like, what did I eat today versus what did I eat two weeks ago? And how did it make me feel that day versus how did you know two weeks ago, so you can start to find those patterns and, and create different pathways for that.
Ben James 42:23
Yeah, and it definitely gets more tuned into thinking about these things. Because, again, you don’t know what you don’t know. And like you say, people think they’re eating well, but actually, you know, they’re not until you actually dive deeper. And again, back to the educational piece, you know, introduce some of these concepts that, you know, maybe you want to you want to think about that, but actually, the impact the impact and the potential and some of the research and information out there when shared is is quite eye opening to a lot of patients. So it’s kind of a privileged position to be in to, to be in that position to help educate and empower people because that’s, that’s ultimately our goal, and it’s empowering people to To get back to what they want to do, and what they, what they love doing and feeling confident that they can do it. And one of the things I was saying to someone recently was, you know, one of the biggest, one of the best treatments I ever give is reassurance, you know, and just making people believe in that they’re confident that they can, they can get back to doing what they love, but it may take some work, and it may take a few different things and approaches and, and a few different people in terms of the input, but actually, you know, you’ve got to believe and that’s back to their kind of mental approach, isn’t it of of believing you’re going to get better as well. And I think if you can, if you can package that up and get people bought in and and believe in then the, the the results speak for themselves, which is, which is what we’re in the game for, isn’t it?
Dr Meghan Braun 43:45
Yeah. And you know, the confidence level to have people just starts to soar when you kind of give them the tools and you let them be a little bit more in charge of their own their own recovery. So often, I think even in PT schools, We get taught like, Okay, if this then this and you have to keep going down this route, and it’s all about the symptoms, and it’s all about just the body or that physical structure, but you can’t just tease out the physical structure from everything else that’s going on with this human being, and their experience.
Ben James 44:18
And personality and variation there you know, it’s like you say, it’s, it’s got to be looked, looked at differently. Jacob you wanted to say something?
Jacob Steyn 44:25
Now I want to I’m just curious, Megan, what is your your typical? If you have an office car, not your performance driven athlete? What’s your general approach your functional approach to working with a core or the low but low back issues? And how would you approach that? I’m just curious.
Dr Meghan Braun 44:44
Um, it usually starts with posture, you know, kind of like what you’re talking about if they’re sitting for a long amount of time. I talked to them about actually setting alarms on their phone. So that when they’re on calls, or they’re doing work that They get this alarm and then that gives them that indication, like, Okay, I need to go stand up and do this stretch, or I need to stand up and just move around, or I need to go get a snack or go to the bathroom. You know, so often people are sitting at their desks or even at home now doing the things that, you know, on their computers, they don’t even have water next to them. I’m like, just get a big glass of water get, you know, tumbler, whatever of water. Yeah. And when you run out, go fill it up. Don’t wait for another hour. You don’t have water, you know. So it’s usually with those office people or, you know, a friend of mine calls them corporate athletes.
Jacob Steyn 45:36
Good one, good one.
Dr Meghan Braun 45:37
Yeah. And that’s it, too. You know, sometimes you just have to get people to understand that yes, just because you’re sitting at a desk doesn’t mean that you can’t be active doesn’t mean that you aren’t athletic in some form or fashion. You know, it’s it’s mindset. You could you can be athletic, you just got to be moving.
Jacob Steyn 45:55
Right. And I wrote in my last newsletter, I don’t know if I told you this bend, but I wrote how so many more people actually, I think they anticipated having more freedom working from home and that they would have less strains and aches and problems from not being at the office. Maybe not even driving, you know, an hour to work in some cases. But actually, people got more injuries. And it was it was getting worse with a lot of people from working at home during this whole curve covered. Well, it’s not over yet but since March, and and that was that was very interesting. And so then I was really getting on to on top of it and telling people you know, you got to you got to move you got to do some squats every half an hour or you got to go for a walk really like you say just the essentials. You need to get that right. because they’d come in you know with never had neck pain always came to me for something else. And now all of a sudden, neck and shoulders are just completely cleared up.
Ben James 47:00
Yeah, I know that the issues that we’re that we’re seeing when I have conversations is this, there’s kind of two elements that that I’ve kind of picked up on one one is the obvious that people aren’t just aren’t set up to work from home. So she would be lying in bed and, and with a laptop, or they just sat at a desk. And then there’s the guilt element that well, this is unusual for me, I better sit at this computer all day and not move because I’m going to show that I’m busy and being productive. You know, on an episode recently, we said you know, get up every even if it’s every 20 minutes to move about or every hour you get a glass of water on top of that water, you know, have a break, have a walk, you know, you’re going to find yourself far more productive. Anyway, not just the musculoskeletal health and everything else, but the mental health and the productivity is going to be far better. You know, so it’s, it is interesting how this kind of reaction to, to this situation. Certainly there’s no ergonomics or very little going into these desks. Because it’s just such a quick and reactive approach, unfortunately, and it is leaving a lot of people in and a lot of problems and back back injuries, back pain, his numbers are going up and they were already high enough already. So that’s a bit of a concern in the in the long term. Where could we be in next year? Well, at least, you know, we’ll be busy!!
Dr Meghan Braun 48:23
That’s for sure.
Ben James 48:24
Yeah, absolutely. I think that’s a maybe that’s a great place to start drawing to a close guys that if you’re listening and active based approach is going to be the way and if you say that now here’s your cue to to jump up and move around because certainly, it’s quite clear from from our side that that movement, functional approach and active approaches is so important to not just back health but but overall health and other things come into play the emotion, the mental health and productivity. There’s so many elements to this, that could be improved not just on the musculoskeletal house, so don’t to brown oui oui. Thank you any any lasting remarks and where’s the best place that people can find you? And we’ll we’ll make sure that we share it all in the show notes when we when we publish this episode.
Dr Meghan Braun 49:11
Yeah, I think you know one of the big takeaways I would say is just find someone that you connect with or that resonates with you as far as you know, if it’s a PT if it’s Cairo, whoever it is, but that understands you as a human and as a person and that you are multifaceted. Don’t just let someone in the medical field, you know, dwindle you down to adjust a spine or just knee and you know, I’m available online as well. So I do telehealth so if people really can’t find someone, I can help you find somebody you know, reach out for sure. www dot body mech mec h PT comm on all social media at body mech PT again, but yeah, I’d love to help out anyone I can and I’m super thankful that you guys wanted me on your show, and maybe Got to connect across the world this is awesome.
Ben James 50:02
Yeah, great stuff, the input all those all those links will be in the show notes as always and some great insight there it’s been great to connect and no doubt we shall stay in touch in the future as we start to change the world in terms of back health.,
Unknown Speaker 50:18
Exactly. What you guys up next time I’m over there too.
Ben James 50:21
Yeah, yeah, that’s for sure. And we thank you again and guys everybody thanks for listening and as always, reach out to us and get over to iTunes give us a rating helps to share the share the content and help more people and expand the show. So thanks again as always for listening thanks again for all the ratings we’re getting in the the reviews, we appreciate it and we will speak to you guys on the next show.
Transcribed by https://otter.ai
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