Let's Ride w/ Paul Estrada
Who else is trying to figure $hit out?
Welcome to Lets Ride w/ Paul Estrada – the podcast where a dad tackles the big questions of life, career, and everything in between, by talking to interesting people that have the answers!
When I turned 18, I lost sleep at night with questions that Google was not yet sophisticated enough to answer: What career should I pursue? How can I be more than just average? And how do successful people get to where they are (was there a secret handbook I didn't know about)? After 22 years of pondering these existential dilemmas, I’ve finally pieced together some answers – An answer that is sufficient for now, but one always in need of refinement.
Join me each week as my 6 ½ year old son, Adrian, throws out a thought-provoking question or idea, and I invite a guest to help me sufficiently respond to him. From learning about money and investing, to finding a passion in life, and exploring careers that can be meaningful for you, we cover it all with a dose of humor and some soundbites of wisdom.
So, if you’re a parent or a young adult navigating these tricky waters, or if you want confirmation that other people are sometimes just as lost as you, you’ve come to the right place.
Let's Ride w/ Paul Estrada
Harvard Trained Physician: Mind-Body Healing
Dr. Mauro Zappaterra Harvard-trained physician specializing in physical medicine and rehabilitation, reveals how our understanding of pain needs a revolutionary update.
Most doctors treat pain as a purely physical problem, reaching for prescription pads and scheduling procedures. But Dr. Zappaterra takes a fundamentally different approach—one that might change how you think about your body's pain signals forever.
"Pain is not just a sensation; it's an experience created by your brain," explains Dr. Zappaterra . When you feel pain, over 48 areas of your brain activate, many processing emotions and memories. This connection explains why stress, trauma, and fear can amplify pain long after physical injuries heal. The good news? This same connection gives us powerful tools for healing.
Through fascinating stories—from baseball players learning to control their emotions to car accident survivors releasing trauma—Dr. Zappaterra demonstrates how simple techniques like the "physiological sigh" and five-second mindfulness practices can regulate your nervous system and transform your relationship with pain. His concept of "micro successes" shows how tiny, achievable steps build momentum toward healing that medications alone can't provide.
Whether you're dealing with chronic pain or simply want to understand the remarkable connection between your mind and body, this conversation offers practical wisdom you can apply immediately. Dr. Zappaterra’s approach empowers you to take an active role in your healing journey rather than depending on medications and interventions that often address symptoms without resolving root causes.
Ready to discover what your pain is trying to tell you? Subscribe now and join us for an eye-opening exploration of the mind-body connection that might just change your life.
I feel like how I've never told anybody how good I was at baseball. Like I used to be like really, really bad. Like when I first started I was like swinging but like spinning and then like swinging I don't remember even swinging for the first time but like when I was in team I wasn't that good. When I was in coach pitch I was like really good at hitting but not good at catching. Now I'm in a single eye I'm really good at catching and I think I'm first one to learn how to catch ball flies, like I practice with my dad and I'm really good at hitting.
Speaker 2:So one thing if you remember, when you were in T-ball and you were in coach pitch, you used to get really upset sometimes yeah at practice. You would get really upset and you maybe wouldn't want to play because you would get so hard on yourself if you didn't hit the ball hard or if you didn't catch it or if you didn't throw the ball in this, you know, in the circle net like you'd get really upset. Do you remember that?
Speaker 1:no, yeah, you don't I never put my mind on it.
Speaker 2:That's why and what do I? What I always tell you is like you, you have to calm down you have to control your emotions right I know and I told you it's really hard to do it I know well that's kind of part of sports is. It is it's really hard sometimes. The physical part of just hitting the ball and throwing the ball. That's the easy part, sometimes the hardest part.
Speaker 1:What I always tell you what's that, like your mind is set your mindset.
Speaker 2:Yeah, so like it's like I don't know.
Speaker 1:I tell you that it's. It's like I don't know.
Speaker 2:I tell you that it's it's a mental thing right, like you have to. You have to control. You have to control your emotions mentally, right. And so there's one thing that you do now that you learned that I think helps you a lot. What is it?
Speaker 1:Deep breaths.
Speaker 2:Yeah, so like sometimes I see actually all the time when you go up to the plate, you like, get set. And you go up to the plate, you get set, then you go Right.
Speaker 1:Yeah.
Speaker 2:What does that feel like after you take a deep breath?
Speaker 1:It's really good.
Speaker 2:Tell me so you take a deep breath.
Speaker 1:Yeah, and it really helps Pretty much. I can now I know how to contact, like contact the ball, do stuff like that.
Speaker 2:But after you take a deep breath, does your body like relax, yeah, and then you feel like you're able to focus more.
Speaker 1:Yeah, and I probably like believe in myself to hit, like I can hit the ball, like I can do it. Even though I'm not really saying it in my mind, I can probably like have that feeling.
Speaker 2:Yeah, well, that's interesting. You said it, so you believe in it.
Speaker 1:So then, like I believe in myself, so like, and the teams when they throw, they throw a lot of balls.
Speaker 2:But tell me about who told you to believe in yourself. I don't know if I ever told you that before.
Speaker 1:Sometimes I just teach myself stuff.
Speaker 2:Oh, that's cool.
Speaker 1:I think I've told you this once or twice.
Speaker 2:Hi, let's Ride. Listeners, it's your friend, paul Estrada. If you've gotten any value out of any of the episodes, I'm here to ask you to pause this episode and take a moment to subscribe to the show. Wherever you're listening to this podcast, if you're a real go-getter, please take a moment to leave a review of the podcast. I'd be indebted to you forever. Thank you for supporting and listening to the show and for going on this journey with us. Pause, subscribe and let's ride. Our guest today is a Harvard-trained physician who specializes in physical medicine and rehabilitation, with a particular focus on optimizing human performance through regenerative medicine, nutrition and mind-body exercises. He helps people manage chronic pain while minimizing or eliminating dependency on medication. Instead, he teaches powerful, simple tools that can help calm the nervous system, manage pain and heal using the mind-body connection. His work has been featured in top medical journals and he's here with us today. I'm excited for our guest, dr Mauro Zapatero.
Speaker 1:So let's ride. Let's ride on through the rain. Come on and take me anywhere that you want to be, so let's ride.
Speaker 2:When you think about your just upbringing and you had mentioned in a previous conversation that you come from a very well-educated family, as I recall Do you feel like in your upbringing you were always kind of on this trajectory where you're going to become a very well-educated person? You just had that pedigree and that was kind of a foregone conclusion. Or did you have any bumps and maybe a more windy road than I might think?
Speaker 3:A lot of bumps and windy roads, for sure I was actually. So I spoke Italian first. Italian was my first language. My parents spoke Italian at home, so I actually didn't learn how to read English until I was about like six or seven years old and I was in first or second grade and I didn't have a very good English. I couldn't read, I didn't have very good English vocabulary and I was in the lowest reading group. I never did well in reading, For instance. I never did well in English. It was very challenging for me. I had to do a lot of tutoring, like extra tutoring, to even stay on par with my classmates in elementary school and in junior high school. It was always one of those things where, you know, I never really thought of it.
Speaker 3:I love playing soccer, to be honest with you. Yeah, and if you asked me, you know I wanted to be a professional soccer player. And yet I think as you're growing up, you kind of start to understand yourself a little bit more and you start to see the world and you start to kind of view the inquiries into yourself and into others and I started becoming more and more fascinated with who I was and how this body formed and stuff. And then it just recognized it was my sophomore year of high school, where it was like, oh, if I want to go to college, I actually have to start getting good grades. And that involves changing some of the things that I'm doing, including, you know, studying at home and things like that.
Speaker 3:And so it was really my sophomore year in high school. Excuse me, that thing sort of shifted for me a little bit and I started focusing a little bit more on academics. But my trajectory was, you know, I love playing soccer and I was offered a spot on the University of San Diego soccer team and the choice at that time for me was you know, do I want to play soccer at U University of San Diego or do I want to go to UCLA and focus on academics and play soccer as a club sport? Or, you know, I wasn't going to walk on to the UCLA soccer team. They were significantly better. I just made the decision that I was going to go to UCLA and focus on academics.
Speaker 2:Sorry, given what you just said, I mean where soccer was such a big part of your life did you struggle with that decision, or was it pretty clear at that point that you decided that you needed to put more weight on the academic side of things?
Speaker 3:It was definitely a decision of do I want to play soccer or do I want to go to academics, but I really felt like I had a. There was a knack for math and science. There was just sort of this understanding of math and science. Even going through high school junior high school I was pretty math and science were pretty easy for me in terms of understanding those concepts. If you think about math, it's a language in and of itself, but it wasn't reading a book, it was reading it in a different sort of language. So it just made sense to me for some reason where for some other people it didn't, and I really liked interacting with people. So even in high school I started tutoring other kids. I really liked it. I really enjoyed education. You know, educating people or trying to make things simple, like it was like taking a complex issue and making it simple. You know that started in high school. So math and science were okay, but everything else English and reading and comprehension if you gave me a paragraph to read, my comprehension of it was absolutely poor and that took a lot of struggles and a lot of extra summer classes and tutoring and stuff like that to get me even to par.
Speaker 3:And right now I still joke with my kids and family I say my son's read more books than I have because he loves to read. I've read a ton of textbooks, right. It's like that was a book that I read, or journal articles in science and nature and cell and things like that. So I very rarely picked up a book that was fiction. All my books were nonfiction. There was always some sort of factual. You know it was a textbook or something about the you know something about the human body or something like that. It wasn't a story For some reason. It was like I would get lost in stories and it just it'd be words put together for me and so I just didn't really understand it where if I got a if I got a paragraph of you know, this is what the cell does, this is inside the cell.
Speaker 3:I sort of I could, I could get it.
Speaker 2:Well that that makes sense because you ended up getting a bachelor of science in molecular cell and developmental biology. So I think that goes very much in line with what you just said. But I guess you know that is such a when I read that degree I had never heard of anything quite. I mean, I've heard of biology, obviously, but some of the other adjectives there are a little bit more foreign to me as somebody that's still. I mean, at this point you're still young, you're 18, 19, 20 years old, picking major like that. What was kind of the impetus or thought behind going in that direction? Had you been exposed to that type of subject matter before? How did you get pushed in that direction?
Speaker 3:Yeah, great question. Fascinating, because I actually was contemplating a math major at UCLA. So I entered UCLA thinking I'd major in math and possibly go into economics, but yet I was always interested in science and medicine and like how the body works. So essentially what I did is I took all the top math and science classes thinking that, okay, I'm either going to become an engineer, a mathematician, some sort of economist, or I'm going to go into science and stuff like that, and so that was the base. Those classes were like the base. That was like the base, the foundation for anything that was more scientific, and so it wasn't like I had to decide too early on.
Speaker 2:So I get that from a technical perspective.
Speaker 2:What I'm getting back to, just from a broader perspective of again just simplifying it, which is you're trying to answer. You are fascinated by extremely complex questions and what I'm telling you is and maybe that's just your pedigree and your education and how you were built I think for a lot of people out there they would come up against a subject like that or maybe read an article about it and just say, like well, that sounds cool, but that sounds really complicated and that sounds like a pretty daunting task, and they just wouldn even like begin to even want to touch that with a 10 foot pole. They'd say, look, I'm going to leave that to the smarter people, but I'm going to go over here and do my thing. So I think my question for you is just a broader sense of like tackling a challenging problem. Like how do people overcome this idea of just like that's too complicated, that's too this? Like maybe becoming fearful of it and just saying, no, I need to overcome this. And like push my personal boundaries and go do this. Does that make sense?
Speaker 3:Absolutely, yeah, absolutely. I honestly think that the majority of the time, when you come up to the problem, I think that the solutions that you want are too big. It's almost like, okay, I want to figure out how a cell goes to, let's say, how one cell becomes an organ, right, we haven't even figured that out yet, right? So let's figure out how one cell becomes two cells, right, and that's so, let's. So, yes, I want to get there, but that might take an entire lifetime and it might not even be done in my lifetime, but that doesn't matter to me.
Speaker 3:What does well, what can we do? Right, and work on kind of knowing and understanding what I can do. Well, can I understand how one cell becomes two cells and what is the mechanism that is in place there, right? And then, once I understand that, who else is working on other sort of you know situations or whatnot? So it's really about not only understanding the problem, but what, based on what we have available to measure, you know changes or to you know to ask the question, or you know whatever it might be how can we measure things that we can actually say are make a difference, are important, and so, looking at that, you that kind of bringing it down to the minimalistic and saying, okay, what can I look at Now? The problem with that is that we're not minimalists. Right, the human body is not enough. The human body is a very complex and so always in the back of your head, you want to keep this structure.
Speaker 2:This is working in a grander scheme of things, and keeping that in mind, so I think I want to take what you just said and make sure I understand this, which is you can face a complex problem and the complex problem on the surface could seem daunting and overwhelming, but if you start to break that down into smaller, bite-sized pieces, it becomes less overwhelming. So now, instead of focusing on how does an organ get to be an organ, it's like okay, but that's like 30 steps ahead. Let me go to step one and solve step one, and then step two, and then step three, and then you solve the problem as a whole. And I'm going to just like again overly simplify things and maybe this is silly, but just thinking about this podcast, okay, and this actually came from my brother.
Speaker 2:When I was thinking about starting this podcast. I was thinking about the end state of this podcast, which is I'm going to have thousands of listeners, I'm going to have a website, I'm going to have sponsorships, blah, blah, blah. Right, all the things that you see from the top 1% of podcasters. Well, that stopped me from pursuing podcasting for eight or 10 months, because I was just like just the thought of what it would take to get there felt way too overwhelming. And he's at my house one day and he's just like yeah, but you're thinking way too many steps ahead.
Speaker 2:Go back to the beginning, make a logo, get a logo started. Okay, do that. What platform are you going to use to record the podcast? What type of equipment? And start answering these questions one by one and eventually get some momentum going, and then you'll get to step 30, but you have to start at step one. And so maybe I'm not the only one that, as a human being, we look at the end state of where we want to get to and then we see that that's way too overwhelming, so we don't even start, as opposed to saying, hey, that's great that you're ambitious and you want to get to step 30, but you can't skip 1, 2, 3, 4, 5, 6, et cetera. So that's my oversimplification of trying to interpret what you're saying Is that.
Speaker 3:Yes, yes, and there's fables and stories about this. It's sort of like two people are walking on a beach and they see a thousand starfish that have been washed up on shore. And two people are looking at each other and goes, my goodness, look at all these starfish. They're going to die if they don't get back into the water. And one person says, well, there's too many, we can't do anything about it. And one person you know and the other person takes one, throws it in and goes well, there's one, yeah, and that's one. And what we use, one of the things that we use in clinical practice, is the SMART goals. I don't know if you've ever heard of that, or-.
Speaker 3:I'm aware of that, yes, yeah, so those are actually really good, because what you're saying is here's my end result, right, a million views, or you know the X, y, z, and yes, that's a good end goal. A lot of people that I work with in clinical practice, for instance, they say they want to lose weight and I go, okay, well, you know how much weight you want to lose. You know 50 pounds, okay, well, that's really hard to do. So what is and what happens when we set these? You know, when we have these goals that are so large, it's like it's good to have them, right, it's good to kind of set that intention of looking beyond. But it's also good to say, like, what is something that I can measure right now, that is attainable, right, that is that number one is relevant. You know, just going through the. You know it's specific, measurable, achievable, relevant. Just going through the, it's specific, measurable, achievable, relevant and time-bound, right. So, yes, 50 pounds, but I get rid of the 50 pounds because if I say, look, I want to lose 50 pounds, well, by when? Right, and a lot of people I know are like, well, in two months or three months, no, 50 pounds we might get to in three years, right, but what can we do in a month? Right? Can we lose two pounds in a month? What is it that is attainable and very specific to you and measurable? You get on a scale, you weigh yourself, right, we know what your weight is. Now we have a goal. It's time bound in that you have 30 days, right? So like even saying, look, I'd like to get five more subscribers in a week, right? I don't know if that's attainable, right or achievable, but you know, based on what you know, you might know it from your perspective of well, I could get a thousand by next week, right? Or five, what's a number that you feel? What happens when the number is too big is we actually set ourselves up for failure, right? So how do we set ourselves up for success If I have 10 micro successes? Now I'm feeding my system with success as opposed to well, I tried that, failed that, tried that failed, that tried that failed that. Why? Because it's like, yes, I have this goal, that's out there, but what I'm hoping is much too soon, much too big, much too soon.
Speaker 3:For instance and there's a book on this called Atomic Habits too, you know, in terms of and so I like that because I call them, you know, in my clinic I call them nudges, Like, how can we nudge you, right? What's a little nudge, what's a little, you know? And this is the same thing with smart, like what you know. And if you think of like atomic right, like an atomic habit, it's not I'm going to run a marathon tomorrow, it's. I'm going to walk five steps tomorrow, right, can I walk five steps Right? Awesome, I got five steps.
Speaker 3:Now give yourself a pat on the back, right, throw yourself a party because you got five steps right. Now can you get 10 steps, okay, well, I think I can get 10 steps right. So then do that, right. And now, all of a sudden, your 10 steps goes to 3,000 steps, yeah, and so I call them nudges. Other people call them atomic habits, right? What sort of atomic habits? What are the tiny, tiny, little, tiny, right? Little practices that you put into place, that atomically, slowly, slowly, change can occur, and what's beautiful about that is even from an atomic level, right Is like you take two, three, four atoms and all of a sudden, now you're creating a molecule and the molecule is completely different than the atom, and now you're putting molecules together and now you're creating a cell.
Speaker 3:So it goes back to the molecular cell and development.
Speaker 2:Well, yeah, actually that's fascinating what you did, like just kind of tying a bow on this, and your fascination with the human development, like exactly what you just said. And Like exactly what you just said you know, and I love the term you use micro successes. I haven't heard that before but I'm going to add that to my tool belt of terminology. But exactly what you said, like it's not, like the human body creates a child with the snap of a finger. You just said one cell builds on another, cell builds on another. So the body is having micro successes and that's how it gets to baking a child in nine, 10 months, Right?
Speaker 3:Exactly. I love that. That's fascinating. Exactly, and usually, you know, I know all my patients, for instance, you know they want to, let's say, they want to get off their medication, or they want to get better at exercising, or they want to do more mindfulness, right, and so what do they do? Okay, tomorrow I'm going to start meditating 30 minutes.
Speaker 2:Whoa, whoa, whoa whoa, whoa, you know.
Speaker 3:Yeah, what can you do that you'll be successful at? And I start them off at five seconds.
Speaker 2:Wow, that sounds doable, right. Yes, that sounds doable. There you go, right, I just got your buy-in right. Yes, you did. I can do that Okay.
Speaker 3:So tomorrow or today, right, Do five seconds of mindfulness and people go. I can do that do that, okay.
Speaker 2:If you can't do five, do one. Yeah, right, okay, are you serious? Like you really start with five seconds? Yes, can we do that right now then, for us and the listeners?
Speaker 3:Absolutely. How do?
Speaker 2:we do that. What do we do?
Speaker 3:Five seconds so stop what you're doing. So pause what you're doing, bring your attention to your breath. Okay, done, that's it, and now proceed, that's it.
Speaker 2:Okay, guys, did you get that Five seconds?
Speaker 1:Don't do it while you're driving.
Speaker 2:Well, maybe you could, but point is, it's not that hard right and, just like you said, it's just a mini. We just did a. I already forgot the term micro, Micro success, Micro success. You just did a micro success while listening to this podcast Five seconds.
Speaker 3:Nice job. You could do that tomorrow for five seconds.
Speaker 2:I don't see why not.
Speaker 3:Exactly, absolutely. And now you do it. So then I say, look, get a calendar, I don't care, right, just put it on the wall. Every day you do it, even for five seconds. Mark an X on that day and you'll start seeing how your whole body starts to resonate with that micro success. You're going to start to feel joyous. There's going to be an element of natural dopamine it's not the screen scrolling dopamine, it's not the drug induced dopamine.
Speaker 3:You look at the calendar, you go, wow, I did seven days of five seconds of mindfulness. That's awesome. Yeah, look at that. You can show your wife, you can show your kids if you have white, or your significant other partner, or whatever it might be. This is what I did Now, right, great job, I did it for 30 days. Next question Awesome, now can you do it for six seconds, seven seconds? Now, instead of one breath, can you take two breaths? Yeah, right, whatever it is, I think I could do that. Right, I'm not going to 15 minutes of mindfulness. I'm not saying tomorrow you're going to do 15 minutes of mindfulness. Are you kidding me? I'm setting you up for failure. I'm going to set you up for failure, okay, and so that's what we do, that's our strategy and we get buy-in and when I tell people, you know, I don't want you thinking a month from now, I want you thinking two years from now. They go that long go, yeah that long you'll be shocked and they go ah, you know what happens?
Speaker 3:their whole body relaxes like, oh my God, I think I can actually do that. Well, good, but what can we do now, in the next week? What implementation, what plan can we put that's achievable, that's measurable, that we know that is going to have 99.9% chance of succeeding? That's what I want to come up with.
Speaker 2:And I think what I was just thinking of, as you were saying that was two years might sound like a long time, and as soon as you said saying that was two years might sound like a long time and as soon as you said it, I'm like that's a long time, but if you think about it as a percentage of the average person's lifespan, you're talking about what? 2%, less than 2%? Yeah, Probably I'm not very good at math, but you know what I'm saying?
Speaker 2:A little bit more than 2%, a little more than 2%. Yes, so a little bit more than 2%. And when I, at least from the way my brain thinks that seems like that's not that much time.
Speaker 2:Yeah, two years, but two years over your life is like very, very little right. So love that. And so now I want to get into a little bit of what you do at your practice, and there's a phrase or some words that stood out to me that I want to dive into, and that is you say non-pharmacological I'm going to try to say this correctly non-pharmacological, non-interventional pain management. So it's a lot of words there, but if you could start to just break that down for us and give us a better sense of what you're trying to do with your practice.
Speaker 3:Yeah. So I run our multidisciplinary programs here in Los Angeles and I work with people who have chronic pain and what I do is I try to get people off of medications. We don't use medications I don't use. We try to. I don't perform procedures per se. If people need procedures, I refer them to others who do the procedures.
Speaker 3:If you need surgery, you know some people do need surgery and so we refer to the people who do surgery.
Speaker 3:And so what we've learned in pain, exercise, body movements, how your body is moving, cognitive, behavioral therapy, stress reduction, balancing the nervous system balancing the parasympathetic and the sympathetic nervous system and really empowering people to not only make smarter decisions for their own care and their own pain, but get them off of medications that have side effects that might be actually inhibiting their progression towards improved function and getting them to be able to move better and function better. So we don't focus on pain, we focus on function, and so I don't use. You know, if I need to, we prescribe medication, but our whole programs are trying to get people off of medications. We don't use, you know, if I need to, we prescribe medication, but our whole programs are trying to get people off of medications. We don't use medications, we don't use injections. We try to want to. We want to try to get people away from those sorts of interventions if possible and really focusing on strengthening and balancing and moving their body better, as well as their mind and that whole mind-body connection.
Speaker 2:Well, I think a lot of us have been conditioned to the medication. I mean, it's a huge topic and we don't get too deep into that, but, that being said, I just think there's definitely a huge push for medications and then people getting addicted to medications as a result of that and things like that. So it's fascinating that you're taking this approach, and what I think I heard from you is that medication is more like this is a last resort, not a first resort. Is that accurate? Absolutely, that's how you think about it.
Speaker 3:Absolutely.
Speaker 2:And so can you help. Maybe people understand that don't know, like myself, the power. I don't know if it's the body, the mind and what people are missing in general medicine, that we should be looking at things a little bit differently and why we should be looking at it differently.
Speaker 3:How much time do we have?
Speaker 2:Let's just go Go with it.
Speaker 3:Let's see. Yeah, so I try to educate a lot of primary care docs. I give lots of talks to insurance companies and stuff like that, really trying to kind of change the language around these sorts of things. Because if you think of pain, so pain is very important, right, acute pain is very important. Acute pain is pain that happens suddenly. Right, you break your arm, you have a chest pain from a heart attack, you're wrestling with your friend and they put you in a half Nelson. You're like all right, I got to tap out. You're tweaking my arm too much, but you tap out because you feel the pain. You actually feel something that's going to happen if they keep on going beyond that motion. That's going to snap, whatever it might be. If you put your hand over a burning stove very important, pull your hand away. So it's a very, very, very important danger signal, danger, danger, danger, danger, danger. That's acute pain, that's the pain that's happened suddenly.
Speaker 3:Right, when you do have pain, it's a very important protection mechanism. So, evolutionarily, pain is actually designed to help protect you. If you think about every single pain that you've had, you've changed what you're doing. It's some sort of you know whether you're sprained your ankle or you have back pain lifting something, you probably didn't continue lifting it, you put it down. If you sprained your ankle, you took weight off of your ankle. You might've put it in a cast or, you know, used a crutch or iced it or something like that. Right, you know, if you broke your bone, you stopped. You might've had to go to you know the the emergency room and get it repaired. If you have a, if you, you know if you're having a heart attack, you have to get it revascularized. You know all all these sorts of things, right? So you're going to change what you're doing. It's a very, very important protection mechanism and it's a very important sensation.
Speaker 3:The sensory input, right. So pain is defined as an experience. Never thought of it that way, but makes sense, all right. So when you feel pain, right. So one of the things that we separate is we separate what we call nociception, which is the sensory nerves sending information up to your brain, and those are like stretch receptors that you notice stretch acid or pH receptors that you notice acid and base changes in your body, temperature receptors cold ice, you know heat, et cetera, et cetera, mechanoreceptors. So there's various receptors that are sending information to your brain when you, if we do the study, for instance, where you're sitting, you're a perfectly healthy 20-year-old human being and you have absolutely no pain, and we stab the bottom of your foot, let's say Many nerves are going to be activated.
Speaker 3:They're going to go from your foot to your spinal cord, from your spinal cord up to your brain. We now know that there's over 48 areas of the brain that light up when you have acute pain, and a lot of these areas are actually processing emotions, processing our memory processing areas, emotional processing areas. And that is when you generate the experience of pain, because actually, after all, 50 areas are lit up and you create an experience of pain. You're going to feel what we call the unpleasant sensation. In your hand, let's say you crush your hand or you stab your foot. You're going to feel the unpleasant sensation, but the pain is actually an experience and it's an emotional and sensory experience that is created by the brain. So everything that we do is actually trying to change that experience.
Speaker 2:Can I give you an example real quick? I just want to make sure we stay on the same page here. So, and again I'm going to overly simplify things as I can. So I'm, you know, my son's in his first year of kid, pitch baseball. Which means it goes from you know T-ball and then the coaches throwing to now you got a seven-year-old kid throwing a baseball at another seven-year-old kid.
Speaker 2:You can imagine some of the things that happen. Unfortunately, they're still learning their bodies and they tend to hit the batter. And I remember early on in the season a kid getting hit with the ball. And what do they do? The first thing they do is they just immediately start crying and it's like they're inconsolable. They go back to the dugout. They probably are scarred for life as far as baseball is concerned. Sometimes the parent can push them back out there eventually.
Speaker 2:But it's like this big, huge, dramatic ordeal and what I found. I was at his game yesterday and a kid gets hit and you could kind of see him pause and kind of thinking to himself first like okay, I just got hit, but he's processing you could see it processing in real time and he decides not to have the same reaction. It's like, okay, I've had this experience before, it's not so bad. And he decides not to have the same reaction. It's like, okay, this isn't so, I've had this experience before, it's not so bad. And he just continued on with the at-bat, and that was from over a period of five weeks, that transformation. So again, I know I'm oversimplifying, but can you speak to what are you seeing in that situation?
Speaker 3:That's exactly it.
Speaker 2:Okay, so can you explain? What do you think happened with that kid? His body or his mind?
Speaker 3:yeah, to allow him to change his reaction yeah that's a great question. You know, you actually said it and saw it in real time. That is sort of like perfect pain management, right there, right. Did he feel he got hit the first time, right, and what happened? Maybe that was the first time he's ever been hit, exactly and it was, and the the response right, yes, it hurt, okay, but what?
Speaker 3:and the response right, yes, it hurt, okay, but what was the response? What was the experience that everybody had to deal with? Sort of a catastrophizing, you know this sort of cat.
Speaker 3:He got hit by a bus Exactly Right and you're thinking do we have to bring this guy to the emergency room? Did he just break his arm? You know, right, and you look and you can't even see a bruise, right, right? That's exactly what I'm talking about. Is that experience that he has went up to his brain? Right? That was then created and emotionally, it's the same areas of the brain that process emotions, that process pain.
Speaker 3:So, emotionally, he lost it, which then triggered the areas of the brain that perceive pain to be heightened. And now, because you emotionally lost it, what happens to the pain response? You're actually going to feel as if you're in more pain. It's sort of like escalating it all.
Speaker 2:It's like a snowball effect.
Speaker 1:Exactly, We've all done this right.
Speaker 3:Now you saw the other scenario. Okay, he goes and sits in his dad's lab, mom's lab, whatever, and maybe they console him, they put ice on it, they rub it and I'll get into all that if you want me to, and then he's fine, right, I don't know if he comes back, or they kind of talk about it, or maybe they even go home and they practice him getting hit by pitches, right, because, look, they're like, look, I know that this is going to be sore, but we don't have to go to that extreme, right? So it's sort of like another level. Right In the next situation he gets hit. Okay, right, does he feel an unpleasant sensory experience from the being hit?
Speaker 3:Yeah, he does yes absolutely Right, right, yep, yes, okay, so we all agree, right? Yes, I could say that hurts, right? What does it feel like? It's a Charlie horse, right, it's a clubbing. Okay, then you saw it. It was like then he was processing it. It was almost as if he could say okay, I'm not going to allow this to affect me.
Speaker 2:Yeah, like this has happened to me before and my arm didn't fall off, so I'm going to be fine and I'm okay, right.
Speaker 3:So is that?
Speaker 2:more like a physical, or is that like you're is? That like training yourself mentally. Yes, that's what it is.
Speaker 3:That's the entire process, right. And so where do I go from here? Right, exactly what you said. Right, this has happened to me before. It was okay, right, so what is he actually doing to himself? He's talking himself down. Okay, the first time it happened, body ouch danger. This is, oh my God, I need my dad. This is dangerous, I'm in pain. Okay, right, goes to dad. What does dad do? And this, if you're a parent? Right, parents are all pain management experts, guaranteed.
Speaker 1:You just don't know it. Okay, all right.
Speaker 3:Okay, Because what you do is exactly what the research shows that we should be doing to not allow people to go into chronic pain, right? So what does the dad do, or the mom? Right Do they say? Do they freak out, right, Do they go? Oh, my God, my kid just got. If they do, what happens to the child?
Speaker 2:They freak out more. They freak out more.
Speaker 3:Right, let's get out of here, we're never coming to baseball right when we've seen that right We've seen that. Now is that person ever probably going to come back to like no, you've just like that situation?
Speaker 2:Exactly.
Speaker 3:Okay, you probably like. Okay, I recognize that my son is having this experience, right, and so what you're trying to do is you're trying to make them recognize that it's not dangerous and so for them it's dangerous. They're elevated, their nervous system has been elevated and even if you remember your kids walking and falling on the ground right and scratching their hands and they do you let's say they're learning how to run and they're running ahead of you and they fall right Do you run over to them and freak out? No, no.
Speaker 2:Definitely not.
Speaker 3:In fact, you want to maybe even look the other way and even if they look right, if they see your expression, if they see your experience, they don't actually know. The first time they do. They don't know what to experience because this has never happened to them before, right, right. So if you come in and give them an experience, give them a reaction, oh my God, mom or dad, the most important people in my life have this shocked expression in their face. This must be really serious. I'm going to have that same expression, boom.
Speaker 3:Or you look away and you go okay, let's see what they do on their own. And sometimes you look and you're like, oh my God, that was a really bad fall, right. And you're kind of like holding yourself, and they get up and they brush it off. And you're like, oh my God, did they just get up and brush it off? Yeah, it's incredible. And then you go, look at their hands and they're like, oh yeah, like I scraped. You know I scraped my hands. You're like, wow, good for you, right? Or other scenarios where they scrape their hands. So let's say they scrape their hands, right, and you come up to them, you don't freak out. What do you tell them? Like?
Speaker 2:first of all, you're okay, you're fine. Why are you saying that?
Speaker 3:You know that they're okay, right, right, right, what you're doing for them. They're triggering a danger response. You're saying you, the most important person in their world. Right, they're infants, they're young kids. They're learning how to walk, run. You're telling them they're okay, you're okay, you're okay, it's a little boo-boo, yes, it might hurt, but you're okay. Right, you continue to bring down the danger response. Essentially, what their nervous system is hearing is yes, it hurts, but you're okay. Yes, it hurts, but you're okay. Right Now, let's say they continue crying, crying, and we've all done this. We just don't even recognize it because it's so natural for us. They continue crying and you're like oh, and now? Maybe in your head you're thinking should I bring them to get an x-ray? Not sure it doesn't look that bad, even if they broke a bone. I always say this even if they broke a bone, what are you going to say?
Speaker 2:You're okay.
Speaker 3:We're going to go to the emergency room and guess what? There are people there who are going to take care of you and you're going to be okay. Even if you have to get a cast, you're going to be okay, it's going to hit, right. You just continuously repeat this You're safe. Okay, we use the words you know, okay. But let's say they, you know, they don't have to go to the emergency room, right, and they're still crying, and maybe they didn't sleep well that night because that affects them, you know, or they haven't eaten, so their mood is a little different because of their blood sugar or something like that. Right, and they're crying. Okay, what do you do?
Speaker 2:You're okay. You're going to be okay again, right? And now they're still crying. What else do you do? You might like rub their back. Exactly, yeah Right, social.
Speaker 3:So social engagement, right. So now you come right. Maybe you hold them, maybe you can rub the area, right? Oh, let's rub it right. Rub the boo-boo right. Okay, let's rub it, rub it, rub it, it's going to make it feel better. Why are we rubbing it Right? Because what we're doing is we're sending signals. Okay, so let's say I injured my arm. Okay, I scraped my arm. Okay, so there's signals that are being sent to my brain from my left you know, I'm just gonna use my left arm. Okay, there's signals that are sent to my brain that say, okay, there's tissue damage that occurred, you know, but I know, but the dad or mom knows it's okay, we don't need to go to the emergency room. Child still feels it's dangerous. And then you rub it right.
Speaker 3:What you're doing with rubbing is you're actually sending the brain a different signal. You're sending the brain the signal of touch, now the brain. What you're actually doing is you're scrambling the signal that's going to the brain. The child can't recognize that. They're scrambling the signal and so the painful response will diminish because you're sending another signal Touch, ice, heat, whatever it might be. You're rubbing it. You're saying, you know, even, rub it faster, harder, right. And so you're bringing in other sensations, other vibrations, and mechanoreceptors are being triggered, grambling the information that's getting to the brain. You're a perfect pain management, I guarantee you right.
Speaker 2:So what's interesting about this, as you're saying, it is as you get older, then, like just tying it back to where we started this conversation, which is now I'm an adult. I'm going to change the scenario this time.
Speaker 3:Now, I get in a we forgot everything.
Speaker 2:Well that's what I'm saying. So I get in a car crash maybe a minor, nothing crazy but I get in a car crash and my back is killing me. It's not like I'm calling my mom and dad and they're telling me Paul, you're going to be okay, You're going to do that, right. So that component of it is now gone, right, you maybe don't have that parent or something to do that, but you were just doing that for your kid. But yet you can't think to do it for yourself or something right. So is that?
Speaker 3:I mean, I'm assuming that you're repeating what I'm saying so that's common right.
Speaker 2:So how do we tie that all back together?
Speaker 3:So the first thing you want to do is make sure that there's nothing dangerous going on. So dangerous going on. So that's why you might hey, you know what? I just was involved in a car accident. Let me get the x-rays, let me get an MRI. Let me make sure there's nothing dangerous. What the problem is is that if you see something right, is it dangerous or not? And that's where we all differ in terms of, from a clinical perspective, what is actually dangerous. Right, arthritis for me is not dangerous. For instance, it might be painful, but it's not dangerous. But yet a lot of people sort of see well, you got these degenerative changes, we need to do something. Well, do we need to do something? I know you're in pain, but I'm going to tell you that there's nothing dangerous, right? So yeah, you're in a car accident. Are you stressed or traumatized by the car accident? Yes, well okay.
Speaker 3:So what is your nervous system doing? Not only is the pain you feel, feel the pain. Let's say you do have a strain. We ruled out anything dangerous, right, okay? So there's no. There's no coda, there's no like impinging. There's no spinal cord injury, there's no. You know, there's no broken bone or anything like that. That needs to be repaired immediately, you know. But yet you're still having pain. And it's been a couple days and you're still having pain.
Speaker 3:And nobody has asked you about whether or not you're feeling traumatized by the accident or what psychologically is being affected is, is your what? How you're replaying the accident in your mind. And the problem is is that emotionally right? We get into a car accident we don't even talk about, we don't even talk about the emotions of the car accident, and so many people are actually traumatized from the car accident and the trauma, where the trauma is being processed, not only in the body but in the brain, is the exact same place that pain is being processed. And so if you have unresolved psychological trauma, that's going to be processed in the same areas of the brain that physical pain is, so you might actually be. They're linked. We just coupled them. They're linked in the brain, in the body.
Speaker 3:What we need to do is that's why we do the treatments that are multidisciplinary, where, if you are in a car accident, first thing is you want to make sure that you're safe. Right, you're okay. You really have to do the exact same thing. Did something dangerous? Can I move my arm? Am I paralyzed? If you're paralyzed, ambulance has to come. You've got to go to the ER so many people. If you can't determine that, then that's where the ER docs, that's where the ambulance comes in and helps determine If you lost consciousness because of a head injury or something like that that might be dangerous. We need to get a CT scan or something like that. But if you have it, you get a mild fender bender, you're shocked, you feel a little pain or what not. You've got to start telling yourself you're okay. Even at the scene of the accident, I recommend people saying you're okay, right, and you know the word.
Speaker 3:So what happens is, when you're traumatized, right, you go into survival mode, and survival mode is fight, flight or freeze, which is the sympathetic nervous system, and many people, when we are in a car accident, we trigger the sympathetic nervous system. We're very stressed, it's a very stressful response and we don't have any way of actually calming the sympathetic nervous system and this is what happens with people in chronic pain as well is that their sympathetic nervous system is overly active and they don't have any exercise or practice to bring on or balance their nervous systems, even in a car accident situation. Right, having practices that you've done prior to help regulate your nervous system will start to bring balance immediately to your nervous system, so that you don't just trigger the fight or flight response and stay in that elevated fight or flight response for many, many days, weeks, months or years and never gets regulated, right. So you know, there's actually a term.
Speaker 3:If something's going on, I'm like, hey, shake it off. Yep, right. That seems sort of like demeaning, doesn't it, dude, shake it off. I'm like, hey, shake it off. That seems sort of demeaning, doesn't it, dude, shake it off, man. Interestingly, the way that I see it is, there's a lot of studies in trauma. Peter Levine's written books on it Waking the Tiger on trauma resolution and studying animals and especially like a gazelle. Like a gazelle if it gets chased by a cheetah, right. So imagine you're a gazelle getting chased by a cheetah and you win, you get away from it, right? Was that a stressful situation being chased by a cheetah? Yes, it was.
Speaker 2:Absolutely.
Speaker 3:Now they win. The cheetah's lost, can't find them lost sight. Gazelle feels like they're safe. You know what they do they shake. They shake. What are they doing? They're actually releasing the excess energy that's built up in their body from the stressful response.
Speaker 3:Wow, releasing the excess energy that's built up in their body from the stressful response wow, yeah so like starting to like, even like, small little movements in your body, because what happens is sort of the you know with the impact. Right, all of a sudden, you, you tense up, there's a huge energetic force going into your body. The impact, even like making sure that there's nothing dangerous and then telling yourself you're okay. If you know that there's nothing dangerous, telling yourself you're okay, that you're safe, and honestly actually starting to consciously remove that excess energy that just built up from that event, whatever that event is, and that involves five seconds of mindfulness, breathing. Right, when we focus on our breath, that's an automatic switch into the parasympathetic rest and digest nervous system. Right, taking sighs Huberman has published on the physiological sigh. Right, if we sigh even a physiological sigh, you do it all the time. When you're stressed, right, you go ah, absolutely Right. Why are you doing that? Because that's actually the body's. When you're stressed, right, you go ah, absolutely Right. Why are you doing that? Because that's actually the body's way of regulating itself.
Speaker 3:Okay, huberman published a great, a great paper on the physiological sigh. It's an inhale in, hold, a smaller inhale in and then a longer exhale and that's it. So it's like a one second inhale, a 0.25 second inhale and then, and so it's. You see how that the exhale is longer than the inhale. It's a big inhale, stop a smaller inhale. You're kind of like expanding the lungs even more. Exhale, great regulator of the nervous system, right, by expanding the lungs, the cavity, right. That's part of the response for our parasympathetic nervous system to actually be activated and our sympathetic nervous system to calm down a little bit. Physiological side, with study, you can do this as little as two minutes, up to five minutes, you'll see. You can even do this if you're not involved in a car accident, if you're stressed, if you're watching your kid pitch at a kid pitch game. You can do that.
Speaker 2:Oh, that resonates with me.
Speaker 3:You can do the physiological sigh and just see what happens with your nervous system. That's funny, right.
Speaker 3:So, breathing techniques, what I said shake it off right. Movement, right. A little bit of like, where you're just sort of like moving, and I do this. You sit quietly and you just notice, like, does your body twitch? Does your body have a desire or want to twitch in any way? Even just letting your arms, sort of like you know, shake off to the side If you've been involved in something or you feel stressed. Even just coming in, doing a physiological sigh, paying attention to your body and allowing it to just sort of like like move and threat, what you're doing is you're getting rid of the excess energy that has built up and is being held in your body, that is not being released, and so you really want to do this. You know you want to do these activities and then also tell yourself that that you're okay.
Speaker 2:Well, I want to um. So, as you were talking, I was thinking about my own experience of this. So I remember about 20 years ago I got in a pretty bad car accident. The roof of the car actually caved in such that I couldn't see my hands on the steering wheel. This day is, if I'm driving on that freeway, my body almost knows exactly where that accident happened the off-ramp. I remember the off-ramp. I remember exactly where I was and even this, 20 years later, I will drive past that and it may not be as big of a deal anymore, but it will at least trigger a very brief like oh yeah, remember when this happened right here. And then I continue on with my day. Now, when that happened, the year after, two years after, I could feel my body tensing up, remembering exactly what happened in that moment.
Speaker 2:Now, 20 years later, but it's still somewhere there in the back of my mind where it's like I don't feel like it impacts me day to day. Maybe it does, but to your point, it's like addressing the physical issue, like, yes, I had a cast on my hand for six weeks and look, it's fine, I can have the same motor skills and everything that I had previously. But there's still this psychological piece that comes back even 20 years later, this psychological piece that comes back even 20 years later. And so I think what I'm hearing from you is that it's very easy to identify and address the physical repercussions of these things.
Speaker 2:Much harder to uncover dig deep and find these psychological things that need to be addressed, and so, as a result, it's like okay, I'm going to put you in a cast, I'm going to prescribe to you some heavy drug for the pain, and that was easy. I addressed that part, but no one ever talked to me about the psychological part, and eventually I got over it on my own, thankfully, but maybe people don't, and so I guess just tying this all together, that's basically your approach to this right, which is you can't ignore this very important piece of the body which is the mind, and in fact that might be. You said you have to address the physical component and make sure you're physically okay, but once you're past that part, maybe what people are missing is we're not focusing on the right ways to heal ourselves after that. Does that sum that up properly?
Speaker 3:And it's really a combination of the mind and the body, because a lot of people, even if you had a cast, are you moving that? Is there any restriction in your movement when you go and grab something? Is there any resistance? Is there any fear of making the movement? A lot of people, even if the physical has been healed, they still have fear in making the movement.
Speaker 3:And so you know, just going through somebody and making sure that people understand what you know, how to strengthen a body part, how to move in a proper range of motion for that body part but, also doing that in a psychologically informed setting, where they're also doing practices that is, decreasing anything that might be arising in terms of stress, trauma, you know, catastrophizing or anything like that that comes up, and specifically doing exercises that look at that, that bring out those emotions.
Speaker 3:There might be some emotions that are still waiting to be processed, and so you know, and so that's a really big component of it.
Speaker 3:So we talk about, you know, we talk about the emotions, we talk about thoughts, we talk about sensations and all this other stuff and how to combat it from a multitude of different angles that we're looking at, allowing these emotions to move and come out and be expressed and be fully expressed, and allowing your thoughts and how do we actually look at the thoughts, even the thoughts around an accident or an injury or, you know, whatever that is, and how are those thoughts coming in today and still activating a circuitry that involves the mind and the body, but then that may lead you to say, oh, there's my pain, right, and it activates you in that way.
Speaker 3:And so what we want to do is we want to find all those circuits and halt them. We've got to redirect them, and we want to redirect them in a resourcing way, using all the micro successes right, because we haven't like so using all the things of, of, of atomic habits and and things like that, where it's like, look, I know you're not going to be able to lift a hundred pounds yet, but let's get you just to lift two, safely and without you tensing up, even, you know, with two pounds, for instance. So that's kind of how we work with it.
Speaker 2:So what do you recommend? So you've mentioned you've given us a lot of great thoughts and ideas on things that we can do when do people get started? So we've been talking about it in the context of okay, you had this accident at this moment, but maybe there's people that maybe they have some sort of lingering or they think is a chronic issue. We talk about these micro successes where do they get started? And just like trying to uncover, uh, what is? I don't know where I'm going with this, but basically, like they're, um, if they want to understand their, their body and their injuries a little bit better and how to address those, like, how do they start? Let me try that.
Speaker 3:That's a really good question. Uh, I'm actually trying to put together a group of physician healers that people can contact that can help people do that. It's like, yes, we know the guidelines and we know all the traditional ways of doing things, but we also think outside the box and try to look at it holistically and comprehensively. I'm not sure there's one place, because everybody is so different. There could be so much. The first thing to try to do is and this just comes back to is find a resource. So a lot of people don't have a resource, or don't even know what a resource is, or use alcohol as a resource, or use food, and so we're obese and out of shape. Unfortunately, I have my own theories about that Food. When we eat, we trigger the parasympathetic response, and so eating is a way of we have to digest the food, and so eating is actually a way of trying to balance stress. Alcohol is a way of trying to balance stress. You've got to find a resource, and what a resource is.
Speaker 3:If you think of natural resources, and if you think about your city resources, and if you think about global resources, what are your resources? What are places that you can go in your body, in your mind or that help make you feel safer. And that's really where to start. And this might not be in the body yet, it might not be your breath yet. It might be going to the beach and putting your feet in sand or putting your feet in water. It might be going out to nature and going on a hike, it might be spending time with loved ones, it might be holding a pet or an animal At first, finding a resource that is there all the time. And the reason I say that's in the body or that's with you is because, going to the beach, we can go to the beach and put our feet in the sand, but right now I don't have the beach accessible to me. My friend is working and so I don't have them accessible to me.
Speaker 3:Because in any stressful situation, in any time of distress, what can you do? You come back to your resource, you come back to a place that actually makes you feel safer and then from there, asking I think from there asking the question right, and some people might not have that resource and might need to go to, you know, a counselor, an acupuncturist, a chiropractor, a psychologist, you know, whatever it is to help find their resource or, you know, to help find a resource. And medication might be a resource for a period of time, but knowing that, you know, hey, I want to try anything that's exogenous and anything that's coming from outside the body, trying to understand what, what its effects and limitations are, and then really trying to find a resource that's within the body, okay, and then going from there and you know, especially if it's chronic pain, you know reaching out to me, seeing if it's an appropriate consult or something like that. But you know we're trying to find like-minded people that that can actually help out with these things as well. So it's a great question.
Speaker 2:I think so. It's basically just find a way, a method to check in with yourself, like give yourself some designated time to just like check in with yourself, see what's going on, reflect a little bit and see where it goes from there. Get a micro win or two under your belt, see where it takes you. Yes, awesome, well, hey, I really appreciate the conversation and I learned a lot. So thanks so much for your time. Thank you. The Rockies ain't too far from here. If we drive all night, the cold air will do you well in the mountain morning light.
Speaker 1:So let's ride, let's ride on through the rain. Come on and take me anywhere that you wanna be. Let's ride and let's ride. Let's follow the skyline and when we make it to the other side, we'll find all the bluest guys.