May 21, 2025 • 25 mins
Too many surgeries are taking place which is why some healthcare insurance providers are requiring true evaluation and rehab before authorizing an operation. Always remember, painters recommending painting, mechanic enginve repairs, and surgeons suggest surgery.
It's what they do.
Chad Gray is co-founder of JointStrong.com and this chat could spare you a ton of needless cost and pain.
It's what they do.
Chad Gray is co-founder of JointStrong.com and this chat could spare you a ton of needless cost and pain.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:03):
Five minutes past the hour. It's third hour Morning Show
with Preston Scott Show fifty three to eighty. I'm laughing
because I've been into Chad Gray's torture chamber on more
than one occasion, and where he is the expert and
there is no doubting that, and now he's in mine.
It's been a while since you and I have talked
(00:24):
on the show. How are you it's been a few years.
Speaker 2 (00:26):
Yeah, I'm incredible. Thank you for having me. This is wonderful.
Speaker 1 (00:28):
No, I thank you for having me over the years.
And let me introduce Chad this way. Friends, years and
years ago, when I was doing a very regimented workout
routine at Titus Sports Academy, I started having some very
low back issues and I was really getting annoyed by it.
(00:49):
And Adam Farrow, one of the founders of Titus Sports Academy.
Adam said, Hey, I want you to see this guy.
Don't go there, don't see the orthopedic surgeon. People go
see Chad Gray. And what happened started a very long
relationship that's probably been twelve years ago, maybe longer.
Speaker 2 (01:08):
Yeah, maybe longer than that, twelve to fifteen.
Speaker 1 (01:10):
And what Chad did for me was he educated me.
And I think that was what was so significant is
that I learned and I've never had that back problem since.
Now He's addressed other issues that I've encountered as I age,
because that's what we do. We age and we encounter things.
But Chad is co founder of something called Joint Strong.
(01:33):
Jointstrong dot com is the website, and Chad give everybody
just a snapshot. What is your mission in purpose with
Joint Strong.
Speaker 2 (01:41):
Primary mission is to reduce the incidents and prevalence and
the overall kind of cost burden that this condition category
of this domain of healthcare, of the muscular skele domain
or the orthopedic domain as many people may know it
as the impact that it has on our society when
you look at this base from a cost respective, if
(02:03):
you look at the health plans around America, organizations like
Capital Health Plan locally your self funded plans and companies
like Michelin and Walmart and organizations like that that you
know they fund their own healthcare for their employees and
their dependents. This particular condition category is now one of
our number one or two highest cost spends in healthcare
(02:28):
and it's created an epidemic. Almost in the last fifty
years in this country, the incidents and prevalence of this
condition has risen dramatically where I think now most of
the study data of the epidemiological studies show that about
half of the population in this country specifically will have
a chronic muscular skeletal condition developed in their lifetime. So
(02:53):
it is truly an epidemic both from the impact it
has on our ability to function and live a high
quality of life as we age, and as a burden
on the society as far as cost goes on the
payers of healthcare services in this country, it has a
tremendous burden on them as well.
Speaker 1 (03:13):
So you've attacked this not just from the physiological the
body the mechanism that is our body standpoint. You've attacked
this from literally a statistical digging into the details and
the data.
Speaker 2 (03:26):
We started our whole journey really diving into the data
and trying to understand really what was the core catalyst
for this phenomenon we were seeing happen around this country
and around the world. What was it that drove the
trends and the patterns that we were seeing in the data.
And this is one of the more studied areas of medicine.
(03:48):
We write about one hundred thousand articles of a year
peer review articles a year that get published in some
of the most well recognized mainstream journals in the world,
and so there was plenty of evidence out there to
show us what was happening, what we were doing wrong
in healthcare while we were seeing these dramatic rises and
costs and incidents and prevalence. But you know, once you
(04:08):
get a system moving in a direction, once we started
practicing medicine in the space, once they start kind of
moving in that direction, it's really hard to change it
as new information and new evidence comes out. So it's
hard to turn a big ship. And we started out
with a really dedicated and focused and rigorous effort to
(04:29):
take that science and build new methods and practices based
on that science and embed them into clinical practices and
clinical applications that really allowed us to produce better outcomes
and better results than historically we have been seeing in medicine.
Speaker 1 (04:46):
Chad Gray with me in studio from Jointstrong dot Com
and Chad, I remember saying to you at some point
in the last few years that I just I'm determined
not to be that person that has of most of
my life at six fourd and some change and ends
up at six feet or five eleven because I just
keep bending over more and more and more. And we're
(05:08):
seeing that. Are we seeing that more and more and more?
Speaker 2 (05:13):
Yeah, we're seeing it more and more, certainly in the
aged population. I'm not necessarily including you in that group yet, Preston.
Speaker 1 (05:20):
I appreciate the Yet we're all ahead and there. But yeah,
but you don't have to be there in that position.
You don't.
Speaker 2 (05:28):
Actually, you know, most of the stuff is completely preventable
and avoidable.
Speaker 1 (05:33):
You know.
Speaker 2 (05:33):
The more frightening thing is, you know, when I first
started in this business thirty one years ago, now, it
was uncommon for us to see teenagers or you know,
young adults in their twenties with these common manifestations that
we saw in the older population, the stiff back, the
(05:54):
her needed disc, the bulging disk, the stiff knee and
shoulder and ankle, et cetera. And now what used to
be perhaps maybe five percent of our population coming into
the clinics now is about a third of it. And
a lot of these changes are created because of our
pattern lifestyle, the habits and behaviors that we have as
(06:15):
humans now in our culture have changed, you know, compared
to let's say, one hundred years ago, when we were
predominantly in agricultural farming society, where we were moving constantly,
moving in ways that were unpredictable, often you know, aggressively moving,
moving to end range as we call it. Those things
don't happen as much anymore. The advent of the of
(06:35):
the smartphone, of gaming systems, of technologies that allow us
now to be more sedentary and sit in postures and
positions we were never designed to be in before, have
now lent to the rising incidents and prevalence of these conditions.
You know, just once again, it wasn't something that we
saw fifty plus years ago, and now it's become unusually common,
(07:00):
frightening to see, as a matter of fact, how many
young adults now, not just our older population, but our
young adults now that have these challenging musculo skeletal issues
that are all once again preventable and avoidable if we
just knew what to do.
Speaker 1 (07:15):
I want to get to that point, but I want
to use as an example somebody that I sent your
way a few years ago that illustrates that in the
healthcare system, in the queue right now, they just aren't
trained to properly treat a lot of things that cause
people to seek out a surgeon and to seek out surgery.
(07:39):
And it was a young man that was he was
going to have an ACLMCL surgery. His knee was bleue up,
but everything in his aftercare was basically wrong.
Speaker 2 (07:51):
Yes, you know, this becomes a difficult conversation sometimes to have,
especially in the healthcare world. You know, if you look
at the curriculum in medical schools around the US, less
than three percent of the curriculum on average is spent
on trying to understand, assess, precisely diagnosed, and then ultimately
(08:11):
select treatment for patients in the orthopedic or muscularis gull
little space. So we've got this massive gap in training
in med school, and then we drop into our residencies
after med school, and there's generally less than two weeks
for our primary care and our internal medicine docs about
how to once again assess and diagnose and select treatment
for this particular population. And so you've got these huge
(08:35):
gaps in education and training, and then you drop into
a clinical practice as a primary care internal medicine doc
and about a fourth of your day is spent on
managing people who are coming in with painful joint systems.
Back pain, knee pain, hip pain, shoulder pain, you know
the common ones, the big five the hip, knee, shoulder,
back and neck or the big five you see. And
(08:56):
so you've got massive gaps in training and you've got
a high volume of payations coming in. Leads to a
ton of variation in how these people get managed and treated.
Speaker 1 (09:04):
And oftentimes they get referred perhaps prematurely.
Speaker 2 (09:08):
For surgery oftentimes, I mean it's kind of the default mechanism.
I think that a lot of your physicians, you're kind
of gatekeeping physicians use as a as a method of management.
Speaker 1 (09:19):
And the good news, folks, is that there are alternatives.
And it's not to say that there's not a place
or a time for surgery. We do it great when
it's really needed.
Speaker 2 (09:28):
We love surgery.
Speaker 1 (09:29):
The issue is do we really need it?
Speaker 2 (09:31):
Do we really need it?
Speaker 1 (09:32):
And that's what we're going to challenge. Yes. Yeah, Chad
great with joint Strong. He's co founder. Jointstrong dot com
is the website we're talking about your back and your
hips and your shoulder and your knees and all of
the different things that your joints just cause you problems.
And over the years, I've had Chad attack multiple things
with me with tremendous success, and I wanted to Chad,
(09:59):
what do the numbers say about how frequently someone has
surgery and it might have been avoidable.
Speaker 2 (10:09):
We work with some fairly large payer organizations, self funded
organizations like Walmart and Michelin and others, and we have
access to detailed claims data, so we can kind of
track a cohort of patients we're seeing inside of our
organization versus those are still seeking care, as we call it,
kind of out in the wild. The numbers of kind
(10:30):
of overutilized or unnecessary surgeries, you know, fall somewhere in
that sixty five to seventy five percent range, surgeries that
were completely avoidable had the right intervention or treatment or
care been provided. So fairly alarming statistic when you when
you consider the impact that has on on your life
once the surgery occurs, and the cost burden of that
(10:52):
to our society, to not only the consumer, but to
the payer organizations as well, a tremendous burden that's there so.
Speaker 1 (10:59):
It might oversimplifying by drawing the analogy that it's not
unlike a weed in your yard that you can just
see the thing and pluck it out if you deal
with it early, or you can end up having basically
a tree grow in your yard and be stuck with
a real problem.
Speaker 2 (11:12):
Yeah, there are clear warning signs that tell us these
things are coming, these joint issues are developing, are coming.
We just don't quite understand the language our body uses.
Sometimes we don't interpret the data very well, as we
say in the clinic, you know, stiffness and pain or
the early warning signs and indicators that these things are
(11:33):
developing and approaching us, and we tend to try and
kind of brush that off. Oftentimes, as we get older,
we use age as our excuse. We go, well, I'm
just getting older. They told me this is going to happen,
so I'm just going to kind of live with it.
Or we'll just pop a few pills, take a few
tile and hal or you know, get a prescription here
and there to kind of deaden or numb the pain,
(11:54):
and we just kind of ignore it and let it
continue to fester.
Speaker 1 (11:57):
And it sounds like you're describing what I told talked
about a couple segments ago with the older person who
starts to hunch over more and more and more. They're
kind of giving up.
Speaker 2 (12:08):
Yeah, they give up. Those changes and mobility are a
direct byerproduct and result of our failure to go to
what we call end range movement. The joint systems adapt
and change based upon the stresses we put through them. So,
for instance, if I just take my finger and leave
it bent for a few weeks, eventually I won't be
(12:29):
able to strengthen anymore. I won't be able to move.
The tissues adapt to the stresses applied to them. We
have structures called ligaments that hold and support and bind
our joint systems together. And those ligaminostructures remain supple if
I use them through their full and entire range of motion.
They stiffen and adapt and change. If I don't, those
(12:49):
gradual adaptations and changes in flexibility, and those passive support
structures around the joint are what lead to most of
the pain and discomfort and stiffness we experience. And once again,
if you think logically or intuitively about it, if if
I just take something that starts to get stiff and
(13:10):
move it aggressively through its full range of motion. I
can avoid that. You know, we've all experienced friend, family members,
or ourselves that have had maybe perhaps a fracture of
a bone, and they put you in a cast, And
what's that joint look like when you come out of
the cast.
Speaker 1 (13:26):
Well, it's stuck.
Speaker 2 (13:26):
It's locked, right, And what do I do for to
that point, I start aggressively pursuing movement. I push it,
I push it, I push it till I restore the
mobility that I lost. That's an extreme example of what
I'm talking about here, you know, where we just to
mobilize something for weeks and weeks and weeks and then
it gets stuck. But imagine a person who sits in
a chair for thirty five years behind a computer and
(13:50):
sits in a sloupstraight forward bent posture and never straightens
up or never bends backward fully in the opposite direction.
Over time, those tissues adapt to those stresses and they check.
Speaker 1 (14:00):
And it becomes more comfortable to be in that forward
leaning position than the one that you're going the other way.
That's right.
Speaker 2 (14:08):
As I change, I adapt and compensate my entire lifestyle
to fit that new change, and then that continue to
perpetuate this transformation not in a good way.
Speaker 1 (14:19):
And so instead of dealing with a little bit of discomfort,
by going the other way and pushing that to the
end range, we avoid the pain altogether the best we can.
But meanwhile it's just encroaching more and more. That's right.
Speaker 2 (14:32):
We instinctively as humans, we're built and designed to avoid
things that hurt. Sure, but in these circumstances you have
to move into the stiffness and ultimately into the pain
to restore the joints normal motion, restore that end range movement,
restore function back to the joint system, and abolish the pain.
These these symptoms are completely reversible. We know that now
(14:56):
based upon the science and based upon our clinical results.
If we just can get to people and teach them
how to change a few behaviors in their lifestyle to
kind of restore what's been lost.
Speaker 1 (15:06):
Back with Chad Gray of joint Strong the website jointstrong
dot com. Chad break down percentage wise, the areas of
greatest concern and who you see the most.
Speaker 2 (15:18):
About fifty percent of the volume in healthcare in the
muscular skull space is spine related, So your low back, neck,
the other fifty percent is predominantly comprised of shoulder and
hip and knee. You've got a sprinkling of elbows and
(15:38):
wrists and ankles here and there, but most of the
large joint systems, the hip, knee, and shoulder, and then
the spine constitute you know, ninety plus percent of everything.
Speaker 1 (15:46):
And the back can be the source of a lot
of pain in a lot of other places that you
don't know. The real issue is in the back. Yeah.
Speaker 2 (15:55):
The spine has a unique ability. Certainly in the instance
where a disc bulges are hernia, it's a mixed contact
with the nerve root. We all kind of understand the
basic presentation of sciatica, for instance, you know where you've
got the radiating pain through your buttck, down your leg
all the way to your foot in some instances. But
even without compressing the nerve root the spine, whenever the
(16:16):
disk structure, which is a ligament, it's the largest ligament
in the spine, whenever that structure becomes stiffened or rigid
more rigid, it has the ability to refer pain into
the shoulder and into the hip, and into the the
thigh and the upper arm. So a lot of the
conditions that we see coming into the clinic that are
you know, not directly you know, located in the in
(16:37):
the region of the back, but they're out in the
in the in the shoulder, upper arm, and hip, and
thigh are actually referred from the from the spine themselves.
The disc structures get stiff, they get a little tight,
and their way of telling us that that's happening is
to refer a symptom or a pain out that way.
Speaker 1 (16:54):
One of the things that I've observed in my time
with you is your a to oftentimes determine whether I have, quote,
an injury that might need a specific type of treatment
versus something that I can work on and get better
in relief. Is you're able to identify pretty quickly whether
(17:16):
a few minutes of this, that, or the other type
of movement can bring some relief or added strength.
Speaker 2 (17:23):
Yeah, most of your orthopedic conditions, musculo skeletal conditions are
not structural defects. There's not something that's broken or damaged,
or the join isn't worn out to the point where
it's bone on bone truly bone on bone. Most of
the conditions that we see coming to the clinic are
simple mechanical problems where the join has gotten so stiff
(17:46):
or it's lost so much motion that it's now aching,
it's painful. The ligament of structures have tightened, or fibroast
is kind of the formal term that's used for that
condition or that presentation. The structure of fibros is and
to get so tight that it's now altering the mechanics
of the joint system. Well, if you think about that
process that phenomena, the person that's best suited to manage
(18:10):
and treat it is the patient. They carry that joint
system around with them all day long. So if I
can find movements or positions that create favorable responses, kind
of a cause and effect relationship between you moving that
way and you reducing or abolishing your pain, then me
teaching the patient how to use those movements really is
the best medicine. It's how we ultimately are able to
(18:33):
self treat or teach people self treatment strategies or techniques
for about eighty to eighty five percent of all the
conditions we manage in the clinics. So most things don't
require injections, they don't require medication, they don't require surgeries,
they require thorough education. They require teaching self care principles
(18:54):
and practices that take that joint system to enrange and
restore what's been lost in what used to be otherwise
supple elastic, pliable structures.
Speaker 1 (19:04):
And sometimes it's as simple as does movement a work
or does movement be work? But one of the two
of them is going.
Speaker 2 (19:11):
To work correct In most joint conditions, you have what
we call a directional preference. One direction of movement's going
to work better than all the others. And interestingly enough,
when you look at the patterns and the clinics that
we have, it most often is moving them in the
direction from where the joint system spends the least amount.
Speaker 1 (19:29):
Of time that makes them off a sense, from.
Speaker 2 (19:33):
Where they hang out at most of the day.
Speaker 1 (19:35):
So if the person's leaning using the back leaning forward,
let's try to find the right movement going back the
other way.
Speaker 2 (19:41):
Eighty five percent of the time back pain is going
to be abolished or significantly reduced by moving them into
what we call extension or backwards bending. And it's not
that's not rocket science to figure out why we bend
forward three to five thousand times a day in our
normal lifestyle. We sit and a flexed or bent forward posture.
(20:01):
How many times a day do you bend backwards to
a pose or equalize that?
Speaker 1 (20:06):
We don't.
Speaker 2 (20:07):
There's nothing in my lifestyle that dictates that movement or
requires it.
Speaker 1 (20:13):
Chad was just telling me, I saw the email from
twenty sixteen when you hit me up about that thumb
of yours, and I'd shared the story about not being
able to hold a golf club or hold a hammer
for that matter, and I thought, oh, man, I said
to you, I must have hurt my tendon or something
like that, and you're going probably not and f and behold.
(20:34):
Within minutes, he's showing me where the problem really is.
It was not in my thumb, It was in my wrist.
But let's talk through to the people right now. There
are people that are dealing with pain in their joints,
and let's focus on the back and or they have
a mom or a dad that's dealing with it, or
a friend or whatever starting point for them.
Speaker 2 (20:55):
Yeah, obviously, if you sit and you listen into the
language that the body's using when you've got these back conditions,
they it tells a really nice story. If you think
about what the kind of daily pattern is that you're experiencing.
If you sit down and you analyze that, you'll see
(21:16):
there's a clear cut pattern there. As I mentioned a
few minutes ago on that other segment, everything has a
directional preference most of the time, unless it's truly broken.
Most of your back paying patients tell you they can't
stand to sit. They don't like sitting down. Sitting is
in a position that's it's inherently filled with flexion. I
sit in a flexed or forward bent posture. They will
(21:38):
classically also tell you when they come into the clinic
that I feel better when I walk. Well, walking's the
only functional activity we do that promotes backwards bending or
extension of the lumbar spine the low back. And so
if that's a pattern that you're noticing, when I bend
too per slouch in the chair, I get stiff and
I hurt worse. But when I get up and walk,
I move better, I feel better, I hurt less. Well,
(21:59):
then don't do't be afraid to explore movement in the
direction it's clearly told you you should be using and
moving into backwards bending or extension and lo and behold
in the clinic about eighty plus percent of everybody we
see with back pain, severe back pain, pain locals of
the low back pain radiating down the leg or not
(22:19):
resolves by us teaching them movement protocols in that direction.
The science, the evidence in the research is overwhelming in
this area. It clearly shows us that not only can
we teach patients to self treat and self manage a
vast majority of back pain by using movement in that direction,
but when we use it prophylactically as a preventative tool,
we can also stop it from coming back again or
(22:40):
from developing it all.
Speaker 1 (22:42):
And so.
Speaker 2 (22:44):
You've got to be willing to kind of lay down
the fear and the worry and the anxiety of pain
in the joint system and explore movement's impact on your
particular condition. Don't be afraid to move a joint that hurts.
And trauma that's very rare though, you know, only about
three to five percent of the cases we see coming
(23:06):
into the clinics come in because there was some event
that occurred, some catastrophic event or traumatic event that occurred.
Everything else is insidious and it's on set. It just
showed up for no reason at all. When that happens,
you have a green light now to start exploring movement,
no matter how bad that joint system's hurt or how
bad it hurts. And you should be thoroughly exploring movements,
(23:28):
specifically in the directions that the body has told you
it would like for you to use.
Speaker 1 (23:32):
And there are different ways of achieving those different extensions.
There are.
Speaker 2 (23:36):
There's, you know a couple of different methods and ways
you can apply that. You can do it lying down,
doing you know, kind of a simple cobra type move.
Speaker 1 (23:44):
You see my stick in the corner. I see your stick. Yeah,
that's my back extension stick that I can I fashioned
it after seeing you. I can move it up and
down my spine to isolate different areas and it works great.
That's right.
Speaker 2 (23:56):
Yeah. So you can do it standing, which you are
you have to do because it's studio here, but you
can do it lying down as well. But those are
the two kind of primary positions where you can start
to apply those movements into the spine. And oftentimes what
you'll see is yet it hurts while I'm stretching or
moving it there. But once I finish, or once I've
done it for a day or two or three, all
(24:17):
of a sudden, miraculously, I'm moving better and I'm hurting less.
When you get that response, you better aggressively pursue movement
in that direction to end range. Get everything back in
that direction, because as soon as you do, I'll guarantee
you most of the time you're going to see it abolished.
Speaker 1 (24:31):
I'm going to end with a statement you made to
me years ago. You said, when you're ninety, if God
lets you live that long, you can have the same
back flexibility you had when you were eighteen. If you
work out it.
Speaker 2 (24:44):
You just have to use it every single day. You
have to go through full en range movement in the
joint systems to stop these changes from occurring. It ain't
rocket science, as I always say.
Speaker 1 (24:56):
No, but the learning is about like it to me.
I've appreciated our friendship and thanks for coming in. Thank you, Preston,
Chad Gray. It's jointstrong dot com where you can learn
more and again just explore the movements and uh trust me,
you will, Uh you will. You will be very grateful
(25:17):
for the time you spent listening. More to come on
The Morning Show with Preston Scott
Five minutes past the hour. It's third hour Morning Show
with Preston Scott Show fifty three to eighty. I'm laughing
because I've been into Chad Gray's torture chamber on more
than one occasion, and where he is the expert and
there is no doubting that, and now he's in mine.
It's been a while since you and I have talked
(00:24):
on the show. How are you it's been a few years.
Speaker 2 (00:26):
Yeah, I'm incredible. Thank you for having me. This is wonderful.
Speaker 1 (00:28):
No, I thank you for having me over the years.
And let me introduce Chad this way. Friends, years and
years ago, when I was doing a very regimented workout
routine at Titus Sports Academy, I started having some very
low back issues and I was really getting annoyed by it.
(00:49):
And Adam Farrow, one of the founders of Titus Sports Academy.
Adam said, Hey, I want you to see this guy.
Don't go there, don't see the orthopedic surgeon. People go
see Chad Gray. And what happened started a very long
relationship that's probably been twelve years ago, maybe longer.
Speaker 2 (01:08):
Yeah, maybe longer than that, twelve to fifteen.
Speaker 1 (01:10):
And what Chad did for me was he educated me.
And I think that was what was so significant is
that I learned and I've never had that back problem since.
Now He's addressed other issues that I've encountered as I age,
because that's what we do. We age and we encounter things.
But Chad is co founder of something called Joint Strong.
(01:33):
Jointstrong dot com is the website, and Chad give everybody
just a snapshot. What is your mission in purpose with
Joint Strong.
Speaker 2 (01:41):
Primary mission is to reduce the incidents and prevalence and
the overall kind of cost burden that this condition category
of this domain of healthcare, of the muscular skele domain
or the orthopedic domain as many people may know it
as the impact that it has on our society when
you look at this base from a cost respective, if
(02:03):
you look at the health plans around America, organizations like
Capital Health Plan locally your self funded plans and companies
like Michelin and Walmart and organizations like that that you
know they fund their own healthcare for their employees and
their dependents. This particular condition category is now one of
our number one or two highest cost spends in healthcare
(02:28):
and it's created an epidemic. Almost in the last fifty
years in this country, the incidents and prevalence of this
condition has risen dramatically where I think now most of
the study data of the epidemiological studies show that about
half of the population in this country specifically will have
a chronic muscular skeletal condition developed in their lifetime. So
(02:53):
it is truly an epidemic both from the impact it
has on our ability to function and live a high
quality of life as we age, and as a burden
on the society as far as cost goes on the
payers of healthcare services in this country, it has a
tremendous burden on them as well.
Speaker 1 (03:13):
So you've attacked this not just from the physiological the
body the mechanism that is our body standpoint. You've attacked
this from literally a statistical digging into the details and
the data.
Speaker 2 (03:26):
We started our whole journey really diving into the data
and trying to understand really what was the core catalyst
for this phenomenon we were seeing happen around this country
and around the world. What was it that drove the
trends and the patterns that we were seeing in the data.
And this is one of the more studied areas of medicine.
(03:48):
We write about one hundred thousand articles of a year
peer review articles a year that get published in some
of the most well recognized mainstream journals in the world,
and so there was plenty of evidence out there to
show us what was happening, what we were doing wrong
in healthcare while we were seeing these dramatic rises and
costs and incidents and prevalence. But you know, once you
(04:08):
get a system moving in a direction, once we started
practicing medicine in the space, once they start kind of
moving in that direction, it's really hard to change it
as new information and new evidence comes out. So it's
hard to turn a big ship. And we started out
with a really dedicated and focused and rigorous effort to
(04:29):
take that science and build new methods and practices based
on that science and embed them into clinical practices and
clinical applications that really allowed us to produce better outcomes
and better results than historically we have been seeing in medicine.
Speaker 1 (04:46):
Chad Gray with me in studio from Jointstrong dot Com
and Chad, I remember saying to you at some point
in the last few years that I just I'm determined
not to be that person that has of most of
my life at six fourd and some change and ends
up at six feet or five eleven because I just
keep bending over more and more and more. And we're
(05:08):
seeing that. Are we seeing that more and more and more?
Speaker 2 (05:13):
Yeah, we're seeing it more and more, certainly in the
aged population. I'm not necessarily including you in that group yet, Preston.
Speaker 1 (05:20):
I appreciate the Yet we're all ahead and there. But yeah,
but you don't have to be there in that position.
You don't.
Speaker 2 (05:28):
Actually, you know, most of the stuff is completely preventable
and avoidable.
Speaker 1 (05:33):
You know.
Speaker 2 (05:33):
The more frightening thing is, you know, when I first
started in this business thirty one years ago, now, it
was uncommon for us to see teenagers or you know,
young adults in their twenties with these common manifestations that
we saw in the older population, the stiff back, the
(05:54):
her needed disc, the bulging disk, the stiff knee and
shoulder and ankle, et cetera. And now what used to
be perhaps maybe five percent of our population coming into
the clinics now is about a third of it. And
a lot of these changes are created because of our
pattern lifestyle, the habits and behaviors that we have as
(06:15):
humans now in our culture have changed, you know, compared
to let's say, one hundred years ago, when we were
predominantly in agricultural farming society, where we were moving constantly,
moving in ways that were unpredictable, often you know, aggressively moving,
moving to end range as we call it. Those things
don't happen as much anymore. The advent of the of
(06:35):
the smartphone, of gaming systems, of technologies that allow us
now to be more sedentary and sit in postures and
positions we were never designed to be in before, have
now lent to the rising incidents and prevalence of these conditions.
You know, just once again, it wasn't something that we
saw fifty plus years ago, and now it's become unusually common,
(07:00):
frightening to see, as a matter of fact, how many
young adults now, not just our older population, but our
young adults now that have these challenging musculo skeletal issues
that are all once again preventable and avoidable if we
just knew what to do.
Speaker 1 (07:15):
I want to get to that point, but I want
to use as an example somebody that I sent your
way a few years ago that illustrates that in the
healthcare system, in the queue right now, they just aren't
trained to properly treat a lot of things that cause
people to seek out a surgeon and to seek out surgery.
(07:39):
And it was a young man that was he was
going to have an ACLMCL surgery. His knee was bleue up,
but everything in his aftercare was basically wrong.
Speaker 2 (07:51):
Yes, you know, this becomes a difficult conversation sometimes to have,
especially in the healthcare world. You know, if you look
at the curriculum in medical schools around the US, less
than three percent of the curriculum on average is spent
on trying to understand, assess, precisely diagnosed, and then ultimately
(08:11):
select treatment for patients in the orthopedic or muscularis gull
little space. So we've got this massive gap in training
in med school, and then we drop into our residencies
after med school, and there's generally less than two weeks
for our primary care and our internal medicine docs about
how to once again assess and diagnose and select treatment
for this particular population. And so you've got these huge
(08:35):
gaps in education and training, and then you drop into
a clinical practice as a primary care internal medicine doc
and about a fourth of your day is spent on
managing people who are coming in with painful joint systems.
Back pain, knee pain, hip pain, shoulder pain, you know
the common ones, the big five the hip, knee, shoulder,
back and neck or the big five you see. And
(08:56):
so you've got massive gaps in training and you've got
a high volume of payations coming in. Leads to a
ton of variation in how these people get managed and treated.
Speaker 1 (09:04):
And oftentimes they get referred perhaps prematurely.
Speaker 2 (09:08):
For surgery oftentimes, I mean it's kind of the default mechanism.
I think that a lot of your physicians, you're kind
of gatekeeping physicians use as a as a method of management.
Speaker 1 (09:19):
And the good news, folks, is that there are alternatives.
And it's not to say that there's not a place
or a time for surgery. We do it great when
it's really needed.
Speaker 2 (09:28):
We love surgery.
Speaker 1 (09:29):
The issue is do we really need it?
Speaker 2 (09:31):
Do we really need it?
Speaker 1 (09:32):
And that's what we're going to challenge. Yes. Yeah, Chad
great with joint Strong. He's co founder. Jointstrong dot com
is the website we're talking about your back and your
hips and your shoulder and your knees and all of
the different things that your joints just cause you problems.
And over the years, I've had Chad attack multiple things
with me with tremendous success, and I wanted to Chad,
(09:59):
what do the numbers say about how frequently someone has
surgery and it might have been avoidable.
Speaker 2 (10:09):
We work with some fairly large payer organizations, self funded
organizations like Walmart and Michelin and others, and we have
access to detailed claims data, so we can kind of
track a cohort of patients we're seeing inside of our
organization versus those are still seeking care, as we call it,
kind of out in the wild. The numbers of kind
(10:30):
of overutilized or unnecessary surgeries, you know, fall somewhere in
that sixty five to seventy five percent range, surgeries that
were completely avoidable had the right intervention or treatment or
care been provided. So fairly alarming statistic when you when
you consider the impact that has on on your life
once the surgery occurs, and the cost burden of that
(10:52):
to our society, to not only the consumer, but to
the payer organizations as well, a tremendous burden that's there so.
Speaker 1 (10:59):
It might oversimplifying by drawing the analogy that it's not
unlike a weed in your yard that you can just
see the thing and pluck it out if you deal
with it early, or you can end up having basically
a tree grow in your yard and be stuck with
a real problem.
Speaker 2 (11:12):
Yeah, there are clear warning signs that tell us these
things are coming, these joint issues are developing, are coming.
We just don't quite understand the language our body uses.
Sometimes we don't interpret the data very well, as we
say in the clinic, you know, stiffness and pain or
the early warning signs and indicators that these things are
(11:33):
developing and approaching us, and we tend to try and
kind of brush that off. Oftentimes, as we get older,
we use age as our excuse. We go, well, I'm
just getting older. They told me this is going to happen,
so I'm just going to kind of live with it.
Or we'll just pop a few pills, take a few
tile and hal or you know, get a prescription here
and there to kind of deaden or numb the pain,
(11:54):
and we just kind of ignore it and let it
continue to fester.
Speaker 1 (11:57):
And it sounds like you're describing what I told talked
about a couple segments ago with the older person who
starts to hunch over more and more and more. They're
kind of giving up.
Speaker 2 (12:08):
Yeah, they give up. Those changes and mobility are a
direct byerproduct and result of our failure to go to
what we call end range movement. The joint systems adapt
and change based upon the stresses we put through them. So,
for instance, if I just take my finger and leave
it bent for a few weeks, eventually I won't be
(12:29):
able to strengthen anymore. I won't be able to move.
The tissues adapt to the stresses applied to them. We
have structures called ligaments that hold and support and bind
our joint systems together. And those ligaminostructures remain supple if
I use them through their full and entire range of motion.
They stiffen and adapt and change. If I don't, those
(12:49):
gradual adaptations and changes in flexibility, and those passive support
structures around the joint are what lead to most of
the pain and discomfort and stiffness we experience. And once again,
if you think logically or intuitively about it, if if
I just take something that starts to get stiff and
(13:10):
move it aggressively through its full range of motion. I
can avoid that. You know, we've all experienced friend, family members,
or ourselves that have had maybe perhaps a fracture of
a bone, and they put you in a cast, And
what's that joint look like when you come out of
the cast.
Speaker 1 (13:26):
Well, it's stuck.
Speaker 2 (13:26):
It's locked, right, And what do I do for to
that point, I start aggressively pursuing movement. I push it,
I push it, I push it till I restore the
mobility that I lost. That's an extreme example of what
I'm talking about here, you know, where we just to
mobilize something for weeks and weeks and weeks and then
it gets stuck. But imagine a person who sits in
a chair for thirty five years behind a computer and
(13:50):
sits in a sloupstraight forward bent posture and never straightens
up or never bends backward fully in the opposite direction.
Over time, those tissues adapt to those stresses and they check.
Speaker 1 (14:00):
And it becomes more comfortable to be in that forward
leaning position than the one that you're going the other way.
That's right.
Speaker 2 (14:08):
As I change, I adapt and compensate my entire lifestyle
to fit that new change, and then that continue to
perpetuate this transformation not in a good way.
Speaker 1 (14:19):
And so instead of dealing with a little bit of discomfort,
by going the other way and pushing that to the
end range, we avoid the pain altogether the best we can.
But meanwhile it's just encroaching more and more. That's right.
Speaker 2 (14:32):
We instinctively as humans, we're built and designed to avoid
things that hurt. Sure, but in these circumstances you have
to move into the stiffness and ultimately into the pain
to restore the joints normal motion, restore that end range movement,
restore function back to the joint system, and abolish the pain.
These these symptoms are completely reversible. We know that now
(14:56):
based upon the science and based upon our clinical results.
If we just can get to people and teach them
how to change a few behaviors in their lifestyle to
kind of restore what's been lost.
Speaker 1 (15:06):
Back with Chad Gray of joint Strong the website jointstrong
dot com. Chad break down percentage wise, the areas of
greatest concern and who you see the most.
Speaker 2 (15:18):
About fifty percent of the volume in healthcare in the
muscular skull space is spine related, So your low back, neck,
the other fifty percent is predominantly comprised of shoulder and
hip and knee. You've got a sprinkling of elbows and
(15:38):
wrists and ankles here and there, but most of the
large joint systems, the hip, knee, and shoulder, and then
the spine constitute you know, ninety plus percent of everything.
Speaker 1 (15:46):
And the back can be the source of a lot
of pain in a lot of other places that you
don't know. The real issue is in the back. Yeah.
Speaker 2 (15:55):
The spine has a unique ability. Certainly in the instance
where a disc bulges are hernia, it's a mixed contact
with the nerve root. We all kind of understand the
basic presentation of sciatica, for instance, you know where you've
got the radiating pain through your buttck, down your leg
all the way to your foot in some instances. But
even without compressing the nerve root the spine, whenever the
(16:16):
disk structure, which is a ligament, it's the largest ligament
in the spine, whenever that structure becomes stiffened or rigid
more rigid, it has the ability to refer pain into
the shoulder and into the hip, and into the the
thigh and the upper arm. So a lot of the
conditions that we see coming into the clinic that are
you know, not directly you know, located in the in
(16:37):
the region of the back, but they're out in the
in the in the shoulder, upper arm, and hip, and
thigh are actually referred from the from the spine themselves.
The disc structures get stiff, they get a little tight,
and their way of telling us that that's happening is
to refer a symptom or a pain out that way.
Speaker 1 (16:54):
One of the things that I've observed in my time
with you is your a to oftentimes determine whether I have, quote,
an injury that might need a specific type of treatment
versus something that I can work on and get better
in relief. Is you're able to identify pretty quickly whether
(17:16):
a few minutes of this, that, or the other type
of movement can bring some relief or added strength.
Speaker 2 (17:23):
Yeah, most of your orthopedic conditions, musculo skeletal conditions are
not structural defects. There's not something that's broken or damaged,
or the join isn't worn out to the point where
it's bone on bone truly bone on bone. Most of
the conditions that we see coming to the clinic are
simple mechanical problems where the join has gotten so stiff
(17:46):
or it's lost so much motion that it's now aching,
it's painful. The ligament of structures have tightened, or fibroast
is kind of the formal term that's used for that
condition or that presentation. The structure of fibros is and
to get so tight that it's now altering the mechanics
of the joint system. Well, if you think about that
process that phenomena, the person that's best suited to manage
(18:10):
and treat it is the patient. They carry that joint
system around with them all day long. So if I
can find movements or positions that create favorable responses, kind
of a cause and effect relationship between you moving that
way and you reducing or abolishing your pain, then me
teaching the patient how to use those movements really is
the best medicine. It's how we ultimately are able to
(18:33):
self treat or teach people self treatment strategies or techniques
for about eighty to eighty five percent of all the
conditions we manage in the clinics. So most things don't
require injections, they don't require medication, they don't require surgeries,
they require thorough education. They require teaching self care principles
(18:54):
and practices that take that joint system to enrange and
restore what's been lost in what used to be otherwise
supple elastic, pliable structures.
Speaker 1 (19:04):
And sometimes it's as simple as does movement a work
or does movement be work? But one of the two
of them is going.
Speaker 2 (19:11):
To work correct In most joint conditions, you have what
we call a directional preference. One direction of movement's going
to work better than all the others. And interestingly enough,
when you look at the patterns and the clinics that
we have, it most often is moving them in the
direction from where the joint system spends the least amount.
Speaker 1 (19:29):
Of time that makes them off a sense, from.
Speaker 2 (19:33):
Where they hang out at most of the day.
Speaker 1 (19:35):
So if the person's leaning using the back leaning forward,
let's try to find the right movement going back the
other way.
Speaker 2 (19:41):
Eighty five percent of the time back pain is going
to be abolished or significantly reduced by moving them into
what we call extension or backwards bending. And it's not
that's not rocket science to figure out why we bend
forward three to five thousand times a day in our
normal lifestyle. We sit and a flexed or bent forward posture.
(20:01):
How many times a day do you bend backwards to
a pose or equalize that?
Speaker 1 (20:06):
We don't.
Speaker 2 (20:07):
There's nothing in my lifestyle that dictates that movement or
requires it.
Speaker 1 (20:13):
Chad was just telling me, I saw the email from
twenty sixteen when you hit me up about that thumb
of yours, and I'd shared the story about not being
able to hold a golf club or hold a hammer
for that matter, and I thought, oh, man, I said
to you, I must have hurt my tendon or something
like that, and you're going probably not and f and behold.
(20:34):
Within minutes, he's showing me where the problem really is.
It was not in my thumb, It was in my wrist.
But let's talk through to the people right now. There
are people that are dealing with pain in their joints,
and let's focus on the back and or they have
a mom or a dad that's dealing with it, or
a friend or whatever starting point for them.
Speaker 2 (20:55):
Yeah, obviously, if you sit and you listen into the
language that the body's using when you've got these back conditions,
they it tells a really nice story. If you think
about what the kind of daily pattern is that you're experiencing.
If you sit down and you analyze that, you'll see
(21:16):
there's a clear cut pattern there. As I mentioned a
few minutes ago on that other segment, everything has a
directional preference most of the time, unless it's truly broken.
Most of your back paying patients tell you they can't
stand to sit. They don't like sitting down. Sitting is
in a position that's it's inherently filled with flexion. I
sit in a flexed or forward bent posture. They will
(21:38):
classically also tell you when they come into the clinic
that I feel better when I walk. Well, walking's the
only functional activity we do that promotes backwards bending or
extension of the lumbar spine the low back. And so
if that's a pattern that you're noticing, when I bend
too per slouch in the chair, I get stiff and
I hurt worse. But when I get up and walk,
I move better, I feel better, I hurt less. Well,
(21:59):
then don't do't be afraid to explore movement in the
direction it's clearly told you you should be using and
moving into backwards bending or extension and lo and behold
in the clinic about eighty plus percent of everybody we
see with back pain, severe back pain, pain locals of
the low back pain radiating down the leg or not
(22:19):
resolves by us teaching them movement protocols in that direction.
The science, the evidence in the research is overwhelming in
this area. It clearly shows us that not only can
we teach patients to self treat and self manage a
vast majority of back pain by using movement in that direction,
but when we use it prophylactically as a preventative tool,
we can also stop it from coming back again or
(22:40):
from developing it all.
Speaker 1 (22:42):
And so.
Speaker 2 (22:44):
You've got to be willing to kind of lay down
the fear and the worry and the anxiety of pain
in the joint system and explore movement's impact on your
particular condition. Don't be afraid to move a joint that hurts.
And trauma that's very rare though, you know, only about
three to five percent of the cases we see coming
(23:06):
into the clinics come in because there was some event
that occurred, some catastrophic event or traumatic event that occurred.
Everything else is insidious and it's on set. It just
showed up for no reason at all. When that happens,
you have a green light now to start exploring movement,
no matter how bad that joint system's hurt or how
bad it hurts. And you should be thoroughly exploring movements,
(23:28):
specifically in the directions that the body has told you
it would like for you to use.
Speaker 1 (23:32):
And there are different ways of achieving those different extensions.
There are.
Speaker 2 (23:36):
There's, you know a couple of different methods and ways
you can apply that. You can do it lying down,
doing you know, kind of a simple cobra type move.
Speaker 1 (23:44):
You see my stick in the corner. I see your stick. Yeah,
that's my back extension stick that I can I fashioned
it after seeing you. I can move it up and
down my spine to isolate different areas and it works great.
That's right.
Speaker 2 (23:56):
Yeah. So you can do it standing, which you are
you have to do because it's studio here, but you
can do it lying down as well. But those are
the two kind of primary positions where you can start
to apply those movements into the spine. And oftentimes what
you'll see is yet it hurts while I'm stretching or
moving it there. But once I finish, or once I've
done it for a day or two or three, all
(24:17):
of a sudden, miraculously, I'm moving better and I'm hurting less.
When you get that response, you better aggressively pursue movement
in that direction to end range. Get everything back in
that direction, because as soon as you do, I'll guarantee
you most of the time you're going to see it abolished.
Speaker 1 (24:31):
I'm going to end with a statement you made to
me years ago. You said, when you're ninety, if God
lets you live that long, you can have the same
back flexibility you had when you were eighteen. If you
work out it.
Speaker 2 (24:44):
You just have to use it every single day. You
have to go through full en range movement in the
joint systems to stop these changes from occurring. It ain't
rocket science, as I always say.
Speaker 1 (24:56):
No, but the learning is about like it to me.
I've appreciated our friendship and thanks for coming in. Thank you, Preston,
Chad Gray. It's jointstrong dot com where you can learn
more and again just explore the movements and uh trust me,
you will, Uh you will. You will be very grateful
(25:17):
for the time you spent listening. More to come on
The Morning Show with Preston Scott
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