September 25, 2025 • 59 mins
Doc & Jacques welcome to the studio Dr GiGi’s twin sister, Dr. Rike Mitchell, a tenured professor at Brigham Young University and physiotherapy expert, to talk about the expanding role of physiotherapy. Dr. Mitchell explains how physiotherapy aids in rehabilitation, such as improving functionality, balance, and independence. The physical therapists are considered the “movement experts.” […]
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:09):
Welcome.
You have now entered the cosmic radio receptors
of KCOW
one hundred point seven FM in Brookings, Oregon.
Thank you for tuning in to this week's
extra
fabulous program.
I'm doctor Gigi, and my cohost is usually
(00:29):
Jacques Kepner,
but he's away for a couple of weeks,
so he won't be here in person,
but certainly in spirit.
And as a matter of fact, I know
he is listening to our show today
in Missouri.
Go Missouri.
So he's having
a listening party.
Hey, Hoppy. Hey, Elizabeth. Is that Purdy?
(00:52):
Doctor Sherry,
Chris Nelson, Darwin,
Pearl, Rebecca,
and of course, lovely Shakhi.
Thanks for listening,
and hello to everybody. So
for this reason, our format for the Doc
and Jacques show is going to be a
little bit different today.
(01:12):
However, as Jockey used to say,
I do want to mention that you are
hearing this live show on KCIAW in Brookings,
Oregon as I said before, but he always
repeats it anyway.
Having said that, the same show will be
rebroadcast
in exactly one week from now each and
every Wednesday on KZZH
(01:33):
ninety six point seven FM in Eureka, Humboldt
at 8AM
in the morning, and then a few hours
later at 1PM at KFUG,
one zero one point one FM in Crescent
City, California.
So as mentioned above, the format is going
to be a little bit different.
And before we start our MD 10 segment,
(01:56):
I want to introduce
our slash my guest today.
I'm not an English major like Jacques is,
so my prologue or introduction
won't be quite as poetic as what you
have heard in the past
out of Jackie's mouth. So
when Jackie and I were thinking about making
this very radio show or
(02:18):
this kind, we subtitled it subtitle it with
ladies first.
We wanted to highlight women who have excelled
in what they're doing best,
especially in a man's world.
One of the first guests that we were
planning on interviewing
is my guest today.
Now, almost exactly two years after starting our
(02:39):
show, we finally got her
here. My guest started her career as a
physical therapist in 1988,
became a certified
manual therapist in 1997,
a board certified orthopedic
clinical specialist,
whatever that means, in 2015.
Meanwhile, she got a master's degree in orthopedic
(03:01):
physical therapy in February
then proceeded to get a PhD
in exercise sciences in 02/2005.
She became a fellow
of the American Academy of the Orthopedic Manual
Physical Therapists in 2016.
She's now a tenured professor in the department
of exercise sciences at Brigham Young University in
(03:21):
Utah.
She was the only female professor in that
department for years, which has, however, since changed.
She has published multiple papers on restless leg
syndrome and low back pain. She has been
invited to speak at several conferences about her
findings and was recognized at the University of
College
and college level for her teaching and mentoring
(03:43):
in 2021
and again in 2025.
Wow. So you wouldn't think this is a
talk show. So, anyway, she also happens to
be my twin sister.
Therefore,
as Jacques likes to say without any further
verbiage from
me, I want to introduce
doctor
Rike Mitchell.
(04:04):
Welcome to the Doc and Doc Show, which
for today, we will rename
to the Doc and Doc Show. Welcome.
Thank you. Thank you for having me on
the Doc and Doc Show.
I came all the way from Utah to
be here with quite some stress, so you
can tell how excited I am about this
opportunity.
Right. So as a matter of fact, we
didn't even have time to talk. She flew
(04:26):
into Medford,
drove down, had to wait at the Jedediah
Smith's Park for some sort anyway. We did
not meet up till
just now before the show.
So but she's here.
So let's proceed
with our MD 10 or MD PhD 10,
I should say. Today, we're gonna be talking,
(04:48):
about
physical therapy
and how it helps with the healing.
Because, you know, she's a physical therapist.
Most commonly known is the physical therapy is
the fact that it restores
some kind of range of motion. Right? Physical
therapists use the techniques like stretching and joint
(05:08):
mobilization to prevent stiffness
or an excess scar tissue formation
to keep the joints
flexible.
But it also is used to rebuild
strength.
So they have those so called targeted exercise
that strengthen
certain
weakened muscle, which of course is crucial for
(05:30):
regaining
function and stability.
So
where I work for example,
we do see patients for deconditioning
after a bout of seborosepsis
or
other
occasions where they need to rebuild
strength.
If I think about physical therapy, I usually
think about the rebuilding of strength. What do
(05:52):
you say? Yeah. So rebuilding strength is an
important factor in PT. But if you think
about it, you could also go to the
gym if it's all about the gym, the
strength. Yeah. So in physical therapy, we also
try to improve functionality
of a person. So we're working on functional
strength,
balance, independence,
and movement dysfunctions. And actually, physical therapists are
(06:15):
considered to be the movement specialists.
Oh, wow.
Well,
let's move on to other things. Physical therapy
can also
prepare for treatments.
Patient can use physical therapy to build strength
and maintain function before
cancer treatment begins,
helping them to tolerate aggressive
(06:37):
therapies better.
We do send patients to physical therapy before
hip surgery, for example.
This is pretty,
new. It's called pre habilitation.
And we,
strengthen. We put people on strengthening program before
surgery. So,
we we teach them exercises that they will
(07:00):
have to know right after surgery when they're
more confused. So we teach them when they're
not confused, and we teach them about what
they can expect to happen.
So I think prehab is a big part
of successful physical therapy.
Yeah. Yeah. We send them all the time.
Not for every joint change, but hip. Right?
Is that the most important part? Hip and
knee. Hip and knee. Mhmm. Physical therapy also
(07:24):
improves circulation.
So exercise and movement enhances
blood flow
to the vital organs and non vital organs,
I'm sure, and the injured areas, which promotes
then faster and more complete healing.
Yeah. This is the part of therapy that's
off that does not often get talked about,
but it is so important to healing.
(07:46):
Could be after surgery, after a stroke, or
any other immobilizing
injury.
Circulation is, of course, always important, but even
more so if you need to get oxygen
to the injured side, like you said. A
lot of people are afraid of moving after
surgery or after they had a problem. Yeah.
And so it's it's it's really important for
(08:06):
us to tell them that
pain is not always
a warning sign. It might just be a
sign for the,
tissue being,
maybe
aggravated, but there it's important for healing, and
it won't make the injury worse.
But you always have to ask the doctor,
(08:27):
and he or she will know what to
do. But chances that the doctor will want
you to move to provoke to promote healings
are big.
Wow. Cool. Alright.
So there are other specialties in physical
therapy. So for example,
we have
physical therapy that helps cancer patients.
(08:50):
That's right. So
one, of course, is the regaining strength coordination
with cancer people who get chemotherapy and then
they're tired and then they're everything is sapped
out of their body because
of the chemotherapy.
Mhmm. Then it reduces
pain and fatigue
(09:10):
by helping them to move around
a way that they can manage without actually
getting exhausted.
And it can manage
side effects.
So
Let me just real quick talk about the
speciality
of oncology physical therapy because that's that's actually
relatively new. The first certification was in 2019.
(09:33):
So if you think about it, it was
six years ago. Ago. And they started with
the process in 2016
when they said, okay, there should be a
special specialty,
in oncology, and then they had to make
sure that the test questions were set and
all that stuff. Oh, very
cool. Yeah.
So some other,
side effects in the oncology is actually the
(09:55):
lymphedema. You can have lymphedema without having cancer,
but especially breast cancer when you take lymph
nodes out, a lot
of people are left with lymphedema, very
waterlogged
arms or limbs. So,
I have sent people
for physical therapy for lymphedema
and
(10:16):
most likely because it wasn't a very known
subject at that time,
they had to travel or they had to
find somebody who was actually certified for that.
It's most likely
super important, I think, because lymphedema is very,
functioning limiting.
Yep. So especially in breast cancer patients or
(10:37):
post mastectomy,
there's a lot of lymphedema in the upper
extremity in one or both arms, and people
lose functionality
because there's just so much fluid in their
arms. And lymph edema
I mean,
lymph drainage, which is the
skilled massage technique for lymphedema,
(10:58):
takes
quite a bit of education
and,
practice.
And,
it's kind of like a specialty within physical
therapy as well, but it can be very,
very beneficial.
Wow. Now you can also have physical therapy
for neuropathy.
So you have some nerve damage leading to
(11:19):
pain or decreased sensation,
which is which is treated with specialized exercises.
What
what to explain nerve gliding,
etcetera.
Yes. Please point this up.
So I worked a lot with people with
neuropathy.
Let me just step back. So neuropathy is
(11:39):
when people lose their feelings.
Could be because of, cancer treatment, but it
could be because of diabetes. I actually think
that I have seen that much more,
that they have decreased,
sensation in their the soles of their feet.
And they don't notice that
maybe they injured the sole and there's might
be some some opening or a wound.
(12:01):
And because they have neuropathy, there's decreased blood
flow to that area. So this area might
get infected and people don't even know about
it. So this decreased circulation to the skin
that comes with neuropathy
is really a double whammy. First, you don't
feel when you injure yourself and then it,
inhibits the healing process. Yeah.
(12:22):
Darn. Okay.
Any other little
excursions?
Yeah. I have a couple more, like, why
we do PT for cancer patients.
And usually, it's to to treat the side
effects like you said. I just wanted to
maybe go into detail. The pain and fatigue
are the worst side effects from cancer treatments.
(12:45):
And,
therapists can't take that away, but we provide
education and techniques to manage
discomfort
and maybe explain or show them some exercises
that reduces the debilitating effects of the fatigue.
And then, like earlier, we help them with,
increased function.
(13:05):
And if,
there's balance problems due to cancer treatment or
neuropathy, then we help with balance training. Alright.
How do you do balance training? Have them
hop on one leg? Well, that would be
for later on, but we have these,
I don't know, three inch cushions,
and we have them stand on it and
(13:26):
just retrain,
the proprioceptors
that are in the ankles. These are, like,
sensors that tell the brain you're standing awkward
or you have too much sway or something
like that. Well, cool. Alright. Thank you. That
was a nice little excursion into physical therapy
and some of its application as far as
I can handle on my side.
You are now warmed up to hear more
(13:48):
about physical therapy and findings and experiments and
results and research
by a professional.
But before
we get into all of it, let's delve
into getting the skinny from my guest today,
Horika Mitchell.
So
here are the questions.
Where were you born and raised?
(14:08):
This was a tough one for me because
it's the same one as Gigi. So we
were both born in Castorpruxel,
which is in Germany.
And we were also both raised in the
Black Forest. When we were about one year
old, we moved to the Black Forest in
heavens,
and we stayed there until
we were older.
(14:32):
Okay.
Well, so and then
we go on
when we got older. Is that how you
ended up? That's when we got older. I
didn't wanna say old because we're still not
old. So so the first pathway that I
happen to know,
because you're my sister, the first pathway to
college was to become a French and physical
(14:53):
education teacher for high school.
You even lived in France for a little
bit. What changed your mind?
So like so many people in Germany at
that time,
I wanted to become a teacher because you
got six weeks of vacation and you got
really good pay. It's not really the same
situation here in The States. You don't really
get paid that much.
(15:15):
And, our older sister, Berble,
she also
was going to be a teacher. And by
the time she graduated, she's five years older,
so she graduated about five years before
us,
she was on the street, basically, because there
were no jobs available as a teacher because
everybody wanted to do it. Yeah. So, basically,
that was my wake up call. And I
(15:35):
thought, what else am I gonna do?
And,
I thought
physical therapy would be great. I really didn't
really know what physical therapy was. I just
received it one time for my shoulder. I'm
like, that would be cool. So I applied.
So how long does it take in Germany
to become a physical therapist? Well, when it
was my turn, it just took two years.
(15:57):
But things have changed. And keep in mind,
it was, let's just say thirty ish years
ago, maybe more like forty,
almost thirty,
that,
that I went to school. So at that
time, it was two years, and I believe
now you can actually get a bachelor's degree
in physical therapy, and that's, of course, more
(16:18):
like a four year education.
Yeah. So did you ever work as a
physical therapist in Germany? I did for about
two years.
Okay. That must have been fantastic since that's
all you say.
When did you move to The States?
Well,
I
visited The States for about a year after
(16:39):
my PT school was done because what is
now called a gap year, I didn't know
that then, I was just I didn't really
wanna go to work full time because that
meant the rest of my life was prescribed.
So I went to The States and teach
to teach German and French at a couple
of schools.
So Marietta, Georgia. Yeah. Marietta, Georgia. Yeah. Marietta,
Georgia. Yeah. And I couldn't afford it. Yeah.
(17:00):
It was pretty fun. And so when I
came back to Germany,
I missed speaking English, and I went to
an American church, and I met my future
husband there. And
after we got married,
we came to The States.
And I've been there ever since. Yeah. What
(17:21):
happened next education wise? And especially, why did
you keep going further and further to get
this and that and all these numbers and
thingies behind your word behind your The letters.
Letters and this.
So I I think education is
exhilarating. I love getting
more skilled or or know more academically,
(17:43):
and I just have fun studying and learning.
So, again, I came over with a bachelor's
equivalent degree in, in physical therapy. But about
that time, all the PT programs in The
States, they transitioned
from
bachelor's to a master's degree,
and they offered bridging programs for those who
had a bachelor's and wanted to become a
(18:04):
master. So I enrolled in one of those,
and five years later, I got,
an MS in orthopedic manual therapy.
And later on, those programs shifted again, and
right now, you get a doctor of physical
therapy, like a DPT.
And I considered pursuing that, but a wise
friend
(18:25):
advised me to go for a PhD instead.
So just for the listeners, a DPT, a
doctor in physical therapy, is a clinical degree
and a PhD
is an academic degree.
And as such, I'm involved in research. And,
I I love academia and I love research,
but I still love the clinical side. So
(18:47):
I treat patients still, and I advanced my
training in manual physical therapy,
and I became a certified orthopedic PT, and
then I became a fellow like Gundy said
earlier.
So I just always try and continue to
to learn and study and get better.
Okay. So let's say you are,
(19:10):
working. So what does a normal day at
the university look like for you?
So this is really funny. I am busy
all day. And when I asked a professor
at BYU where I was before I started,
I asked him, what do you do all
day? And he said, oh, it's just always
busy. I do research and meet with students.
I'm like,
how busy can that be?
(19:30):
So
but I am so busy. I'm I spend
a lot of time preparing and teaching classes.
I teach two classes a semester.
I meet with students about their coursework and
research. I collaborate with colleagues on teaching
and research projects.
I'm the graduate coordinator, so I work closely
with graduate students and their mentors.
(19:51):
Right now, for example, we are revising the
PhD comprehensive
exam to better align with the BYU aims.
And then lastly, I'm also the faculty
liaison
for the PTOT,
which is occupational therapy club, which means I
regularly meet with students involved in that group.
And when the teaching, advising, and meetings are
(20:13):
done, I finally get to dive into research,
which I really love. I collect data. I
write and explore the latest
literature.
Okay. Though, also, you teach two classes this
semester, what classes do you teach? So this
year, I teach orthopedic
impairment,
(20:34):
which is a class that focuses on joint
problems, including the spine. We talk about scoliosis
and how to design exercises to help treat
them.
And then I teach, but not this semester,
advanced musculoskeletal
anatomy where students learn more than just the
fundamentals.
We learn terminology,
bones, nerves, muscles, and ligaments.
(20:57):
And at the graduate level, I teach in
extremity mobilization
where students practice techniques to mobilize the joints
of the arms and the legs as well
as, get this,
the larger nerves. We mobilize the nerves, which
you earlier mentioned, that's nerve gliding.
Oh. And then, lastly,
I just started teaching a brand new class
(21:19):
that's unique to BYU, and it's called University
one zero one, foundations for student success.
Yeah. It's kind of fun. What is it?
Has nothing to do with physical therapy. No.
No. No. It's like I we get all
the freshmen. There's, like, two hundred and fifty
secondtions offered to catch all the freshmen, and
we wanna make sure that they have friends
throughout the time because there's so many students
(21:41):
that graduate and they never had a friend.
They never had a a peer that they
hung out with. So we do a lot
of,
get to get to know each other. They
talk about the idea behind BYU, and and
it's just a really fun,
in parenthesis, a lot of work for me,
class for the students.
Okay. So you said you teach orthopedic
(22:02):
impairment or exercise or something. Wouldn't that be
something fun for people,
you know, people who have that, not just
for the students? Can you go and do
a service and teach go to a hospital
and say Yep. Well, I could.
But
but, I need to free time, I mean.
I was just gonna say that, I was
asked once to talk at, in our gerontology
(22:25):
department about those things. So if I get
asked, or there was a university wide, it's
called Well and Wise, and I talk about
how to take care of your back. So
I do. I just I don't look for
those opportunities,
but maybe I could. Well, you'll have some
pearls for us later on in right now.
I do. I'm excited. Take that away.
(22:46):
Do you have graduate and undergraduate students? Yeah.
Right now, I have two master's students.
One is in her second year, so she'll
be graduating in a year, and one that
just started. And then I have seven undergrad
students that
help me with my research or I mentor
them.
How to do research? Is that what you're
mentoring them? Yes. Do they get paid? Yes.
(23:08):
Woah.
Dang. Okay. So
tell us about your research. What do you
research?
So I probably won't shut up. So you
have to tell me when you're done. In
three minutes I mean, in seven minutes, I
have to do the mid breaks.
Okay. So my current research focuses on chronic
low back pain. More specifically, I'm studying pain
(23:30):
that comes from the interretibial
disc.
A healthier disc is typically
more hydrated. It has more water. So one
part of my studies
are exploring ways to improve disc hydration as
a potential treatment.
If we could figure out how we can
increase the water content in the disc, I
think we can keep it healthier longer. Drinking
(23:50):
water.
Yeah. That's what students ask me a lot.
Is it helpful? I'm like, yeah. I mean,
you shouldn't
be dehydrated,
but I don't know whether more water will
pump more more water to the disc. But,
I mean, nobody has done that research because
I looked at it.
I wanna be co author.
So I'm also collaborating with colleagues in the
(24:12):
mechanical engineering department to study how people with
chronic low back pain move.
We're trying to find clusters of movement patterns
that maybe we can use to
design treatment options for. Once a pain has
moved on to chronicity,
the brain has changed. The synapsing changes. There's
(24:35):
just this big overlap. Synapsing?
Like,
connecting.
Information
from nerve to muscle? Yeah. Yeah. Yeah.
So so that has changed. Plus, there is
this
psychosocial
overlap, meaning psychology and the social environment
just changes when you have chronic pain. So
(24:56):
we're trying to find out if we can
find movement clusters. We call it phenotyping.
Maybe,
let's say, we have seven phenotypes, and we
can treat these different phenotypes differently and get
them better. So seven different ways of how
people describe their lower back pain? Well, we
have we actually have the move.
(25:16):
So the engineering department has developed these sensors.
So we have a move, and some move,
always
slower into into forward bending, or they don't
like to twist or something like that. It
has to do with speed and their range
of motion, how far they go, and we're
hoping to find these clusters
that we then treat. Because by the time
(25:37):
a pain has moved into chronicity, it's super
hard to find the origin or the etiology.
And once you find it, it might not
even be there anymore because you have that
psychological
overlap.
So okay. So you find some you find
your clusters, seven clusters, seven ways It must
be five.
Of how people move when they have certain
(25:59):
back pains.
So then what? I mean, how do you
help them? Well,
in theory, we Yeah. In theory. We're not
there yet.
But in theory, we think if they have,
like, they don't reach forward as much as
normal people do, then we would maybe do
mobilization
or range of motion
into
flexion. Right? What they're impaired and not worry
(26:20):
about the cause, just what are they impaired
in. And
and our assumption is when they move like,
quote unquote, normal people do, those without chronic
low back pain, we might have helped them
with the pain as well.
Okay. How's that been done yet? I mean,
does that research come from an origin saying,
hey. This person who always stooped over a
(26:40):
little weirdly and now we tell him how
to stoop, otherwise he has no more back
pain?
No. That's why we're in this life.
We're trying to find whether that works. Nobody
has done the phenotyping.
Oh. Because everybody's trying to find the origin.
But by the time Yeah. Yeah. Oh, okay.
So that's the newest approach. Because for back
pain, when you have, I don't know, whatever
(27:01):
the x-ray says or the MRI says, then
I said, okay. We'll send you to physical
therapy if the, you know, the neurosurge is
not indicated, and we hope that the physical
therapies know what to do. You know what?
This brings up a fantastic point.
We get a lot of people that have
and come back with the MRI and say,
the MRI says I have this and this.
Well, guess what? The MRI picks up everything.
(27:22):
We call it it's very sensitive.
So it picks up everything even if the
pain doesn't even come from that. I might
have a herniated disc, for example, but I
have no pain. Yeah. Somebody else might not
have something that is shown on MRI Right.
And they have pain. So
Right. So we're trying to just take that
out and just do the movement clusters. Okay.
But so so far, somebody has scoliosis.
(27:44):
Let's pretend I know it's not the real
treatment, but let's just pretend scoliosis
goes to,
physical therapy. We just send anybody, doesn't matter
what the degrees
are, are to physical therapy.
How are the physical therapists
educated in knowing, well, this is really the
wrong we don't or or you have to
do whatever what cluster one does and not
(28:05):
cluster
two. Do they know? How do they get
the training? Well, if they come because they
have scoliosis, it's not chronic low back pain
or, you know so I'm That was an
example. I know. For the list of leases
or whatever, nobody knows when talking. No. I
I was just trying to understand what you
were saying. So I don't know whether I
understood correctly, but we don't care why somebody
(28:27):
has chronic low back pain, if it's scoliosis
or whatever big word.
We would we think
that once it's chronic, they just need a
certain treatment. We just don't know which one,
so we're thinking about the movement pattern. That's
not what you were asking, No. I'm asking
yeah. So that's kinda like I'm asking. Right
now, the phys the physical therapist, you have
(28:48):
this diagnosis, so you do this treatment. Right?
I mean, that's how it is now. So
you're trying to actually
go a little bit deeper and then
the physical therapist still have to be trained
for that. Yeah. You're right. I'm sorry. I
misunderstood.
Yes. Right now, you come with scoliosis and
you should do certain things that Yeah. Almost
prescribed. Right? Yeah. Yeah. That's what I thought.
(29:08):
Mhmm. Well, but guess what?
We are halfway done already.
So time flies when you have fun. It's
that mid break time at the Doc and
Doc Life radio show. Okay. Doc and Doc
in real life.
And we are proudly broadcasting from the KCIW
one hundred point seven FM
studio in lovely coastal Brookings, Oregon, and I
(29:32):
wanna
list the major sponsors
for our community radio station.
We have Advanced Airlines,
which is flying in and out nearby Crescent
City to Oakland and Los Angeles seven days
a week. Michelle Buford with our own vibrant
local Curry County Chamber of Commerce.
Nick and Lisa Rail, Anthem PPA, the Partnership
(29:56):
for the Performing Arts,
remembering the
no. Don't remember anything. The medical team at
the Checo Medical and Aesthetic in Harper where
I happen to work.
And,
yeah, me and Jackie, we are the sponsors.
On case on behalf of KCOW,
thank you
all of us. So let's go back to
(30:19):
our guest here, doctor Rica Mitchell, my twin
sister,
who is a physical therapist
exploding into PhD and whatnot. So, you have
to scale back and find out all what
she has done. We're talking about her research
in
low back pain, and I think I start
to understand what the research is for. It's
(30:39):
for the future. It's for the next generation
who then knows how to treat the different
clusters.
Unless you have anything else to say, I
wanna ask, how do you do research?
So first, you have to find a field
that you're passionate about. For me, it was
low back pain or chronic low back pain,
(31:00):
and I even was interested in that as
a physical therapist.
Then
you dive into the literature and read everything
you can find. You will find thousands
of papers, so you have to not narrow
it down. For example, I narrowed it down
because I came in became interested in
why do intervertebral
discs dry out.
(31:22):
I tried the increased water intake. That didn't
feel like Go, go, go, go. So then
I thought it was part of aging, so
I'm thinking there must be a way to
slow the process.
And just just so maybe the listeners can
appreciate, it's a super
interesting
subject.
I wanna explain real quick how a disc
(31:43):
works. It's kind of like a sponge.
Compression, when you push on it, that pushes
the fluid and way waste products out, which
is good. And when you pull on it
or let it sit there without pressure on
it,
then it sucks up the fresh nutrients and
water.
Yes. Exactly like that. So that let me
(32:05):
wonder,
could certain physical therapy techniques improve
this hydration?
And when I looked at the literature, I
realized nobody
has worried about that. Again, that's why I'm
in this life.
There was a research gap, and filling those
gaps is how new knowledge gets created. Yeah.
So sometimes, though so I was just wondering.
(32:27):
Right? And I made my own thoughts, and
and I found a gap. But sometimes, it
starts with a new hypothesis.
For example,
in my case, I wondered,
when you run, you have with every step,
you kind of squish water out of the
disc. And then when you're in the air,
ever so slightly,
there is some
(32:48):
distraction
on the disc and it can suck up
the fluid like you just said. So I
thought,
is running good for low back pain, chronic
low back pain? And keep in mind, not
if you have a fracture or if you
know exactly what what's going on. I'm talking
about the disc is the culprit. Right?
So we did And not protruding and pushing
(33:09):
on the spinal cord. Right. Just
a degenerated bit. Degenerated,
the wear and tear.
So,
basically, the essence of research is you ask
questions,
find gaps in what's known, and then you
design careful studies to fill those gaps.
Okay.
For example?
(33:30):
Well, since I talked about the running, we
did this study where we
invited 40 people with chronic low back pain
to our study. 20
were put on a running program, and 20
just did whatever they did before,
which was not running.
And we found out that,
(33:52):
most of them so statistically,
significantly,
amount of people
had decreased pain
after the running program.
And and we also found out, as an
FYI,
that
people
are afraid of running. They don't think I
hate running or I'm lazy. They're afraid that
it makes it worse because they're being told
(34:13):
from neighbors or something,
somebody that it's bad for you. So they
thought, well, I'll try it because, you know
Well, isn't it? It's not. Well, it depends.
If you have a fracture, obviously, it's bad.
But if it's just a degenerated disc, which
usually or often chronic low back pain comes
from, then it's actually a good thing to
do. Hey, Shnole.
(34:34):
Yeah.
Okay. What is a physical therapist's favorite coffee?
Oh, I know that one.
Tinto Face Latte.
Nice. Okay. Continue.
That was my plucky intermission.
Go ahead with your low back pain stuff.
Yeah. We're good. That was that was a
(34:54):
good finding with the with the running and
it being good. Okay.
So,
what can one do now that we have
our low back pain because we have gone
we have been around the block a couple
of times.
So we don't really wanna be running anymore
because
running
that has shipped that has, you know, that
ship has sailed. We're already older. So what
(35:16):
can we do?
So you don't have to necessarily be running.
And and I should have been more clear.
It was a running slash jogging slash walking
program. Yeah. I like the walking. There,
like, the participants were told every week how
far did you go, and then let's add
something,
to the distance. They might have just gone
twenty second at a time and walked for
(35:37):
two minutes, so the next week they maybe
ran twenty five seconds or so. It was
slowly increasing
in magnitude,
but still, you know, it helped. But for
those who have chronic low back pain, any
movement is good. It's good for so many
reasons, cardiovascularly.
Right? I mean, if you bring your heart
rate up, cardiovascularly, that will
(35:58):
help. And,
chronic low back pain will,
not want to be a couch potato, so
you need to get off
the couch or off the chair and just
move around.
Backs want to be moved for the reasons
I explained. You know? It wants to be
squished, and
it wants to be in a situation where
it can Yeah. Yeah. Free floating in the
(36:20):
air.
I like that. Yes.
Okay. So it happens too that you don't
just do the talking, you also do the
walking.
You're known to have run marathons,
many of them. Is that still something you
do?
No. I ran 20, which was a goodly
amount. A goodly?
(36:42):
Yes. But, no, I don't run anymore because
my knees
have vetoed that sport big time. But I
still stay active. I try and do at
least an hour of cardio every day, which
I won't get to do today because I've
been
sitting down since 7AM to get here. Because
she flew in here, and then she was
in the car.
But I We'll be at the beach later.
(37:04):
Yeah. Yeah. But I lift weights from time
to time. I personally don't like it, but
I know how important it is because our
bone density goes down with age. So lifting
weights is it doesn't have to be tons
and tons of weight, just
some poundage that will benefit the bone strength.
Yeah.
(37:24):
So you told us about how to design
the the test, like, you know, frolicking
in
frolicking in the air.
And I was thinking about
any other
fun
stories that you can enlighten our hearts with
while designing a research.
(37:45):
I I really have a funny story to
tell. Actually, I I thought it was funny.
Maybe you guys don't think it is.
But,
a few years ago, I wanted to study,
very apropos,
whether the intermedieval disc
absorbs water when placed under traction.
And because that was known then. And I
(38:05):
wanted to put the person
in in the MRI, take an MRI
before, and then while in the tube, put
weights
on the person.
So To stretch them. To yeah. To stretch.
Yeah. Now you probably all know that you
can't bring ferromagnetic
materials in. So anything like, metal,
(38:26):
you can't bring in. So my then PhD
student and I decided to get creative. We
built, like, a scaffolding, like, a traction scaffolding
using PVC pipes
around the MRI tube,
and we wanted to hang about 20 pounds
of water weights using milk jugs filled with
water.
So we did that, and we thought it
(38:48):
was just the best idea when the whole
scaffolding
scaffolding
collapsed
in the MRI
room.
So we had to we are not engineers,
so,
we had to redesign this whole thing. But
it did work, and it was a great
study. And I did show that traction increase,
(39:08):
water hydration in the discs. So what do
we do with that knowledge?
Yeah. That's a good idea.
I mean, it's a good thought. I I
tell you what I do.
At any time I can, I push off
a seat, for example, like the arm rest?
And I push off that my bum is
kind of in the air. It doesn't have
(39:30):
to be that high, but, you know, you
take the pressure off of your bum when
you push up. Mhmm. And and when you
listen carefully, which I always do,
you do hear the discs make the sound.
Because
they do
take in the water. We call it imbibe
(39:52):
the water. They they do some imbibition, which
means that
new water nutrients come in. And then when
you let go, you feel the water come
out again. And if you think about it,
after you go for a long walk or
if you,
run, then you are actually shorter after that
exercise. And you're also shorter at the end
of the day if you sit or walk
(40:13):
a lot because the fluid within your discs
gets squished out. So you wanna make sure
that during the day, you can get it
absorbed again. So this is a good exercise.
And so how long do you hold it
up there? So I can't, but preferably would
be two minutes. Two minutes has been shown
to make you get the biggest bang for
your buck. But if you do if you
(40:34):
do, like, ten seconds at a time, just
do it when you have to sit all
day. It's very beneficial.
But I have another one too. Oh. So
when you gray tail.
You lie down on your back and you
bend at your hips and your knees about
90 degrees. It's the ninety ninety position.
And then you put your feet on
(40:55):
a cushion or something and push ever so
slightly with the feet down.
That kind of lifts up your bum too,
but it also elongates
the the spine.
So in that position, you don't have gravity
pulling down, but so it's gravity eliminated
almost, and it has time and
hopefully enough fluid to get
(41:19):
dehydrated. But you have to listen carefully.
Okay. So what about
the inversion thing, inversion chair? Oh, so I
have an inversion
table. Table.
So what it is is it's like a
board that you strap
you you stand at it,
you strap your legs in, your feet, and
(41:41):
then it tilts backwards.
So theoretically up to a 180
degrees down, like, perpendicular to the ground, but
you don't have to be that much inverted.
You can be like All the blood is
in the head then. Yeah. The I mean,
and and especially in the beginning, you you
might not like it. But I've done it
for so many years. I love doing it.
So you go down to if 90 is
(42:03):
horizontal, maybe a 120
degrees or so,
and just sit there. And I tell myself,
because research has shown it, two minutes is
enough. But start slowly. You don't wanna have
a stroke because you have to I know.
When the eyes pop out, maybe that was
too long.
Pick them up, put them back in, and
then don't do it that long anymore. Yeah.
(42:26):
So
the research sounds
fun. Who pays for it?
Yeah. So I'm super lucky.
Our department pays a lot for it. We
can just ask for an internal grant, and
we usually get it granted.
If if
the chances that the paper gets published are
great. But, I mean, you don't get tens
(42:47):
and tens of thousands of dollars. I mean,
a couple thousand to pay for subjects, for
example.
And then I'm super blessed because we can
use
we have an MRI at BYU,
and we pay a couple $100 per hour,
for example, to use it for research.
It's not meant to be a clinical device,
but for research,
(43:07):
we can use it. And we get
$5,000
a month to use it for free. Dang.
I should have done that. I came down
there and then something happened. Why did I
not get that MRI?
I think we wanted to do a DEXA.
Or or may I may that.
Do you have a DEXA? Yeah. We do
have a DEXA scan for? So the DEXA,
tells you bone density,
(43:30):
and and it it's, like, super fast. Whole
body scan takes, like, fourteen minutes or so.
Super fast. Okay. Well, it's actually seven minutes,
but then you also do the extra bone
stuff like the spine and the hip. So
and that's, like, the whole package.
And, it tells you bone density of the
hips and the spine because that's usually where
you have the fractures. Like, you fall and
(43:51):
you break your hip. Or
interestingly,
often, you break your hip and that's why
you fall because your bones are so brittle.
So we have that scan. It can also
tell you, like,
body fat
percentage
and lean tissue,
stuff like that.
All the important stuff to start losing weight.
(44:12):
So let's go back to the more oh,
wait. I first wanna do a joke. What
did the physical therapist say to the bodybuilder
with a herniated disc?
You don't know squat.
These are these are Jackie,
type.
Jack Jack.
What advice would you give the younger generation
(44:33):
that are pondering going to
the academia?
Yeah. So I'm obviously a fan. So I
would tell them, if you enjoy research, then
absolutely go for it. It can be a
blast. It's awesome.
An academic career is is so rewarding as
well for me. And you get to explore
new ideas. You get to mentor students.
(44:55):
And
in many ways, I think their energy
is what keeps me young,
miss younger than
my sis
I work with older people.
What?
So
often students ask me, I don't really like
to do research, but I love teaching. Should
(45:16):
I go? Should I get my PhD? And
I'm like, I don't think so because really
PhD is
is really about research.
So
so I don't tell them not to do
it, but I'm more cautious there.
Because the academic route is almost
always
research involving.
And research does not just,
(45:37):
you know, translate into milk cartons and PVC
thingies.
It means
writing papers and looking up stuff. Although, chat
GPT would all make that research much easier
now. But writing and writing. Oh, how do
you write? Do you write your own stuff?
I absolutely write my own stuff. Plus, I've
been writing for twenty well, for
(45:59):
eighteen years. So JACOBD
wasn't really invented then.
JACOBD
has its place, but I don't know whether
it can fully write a paper and be
trustworthy.
I have asked it before, can you give
me some, citations
or, you know,
some some ideas of who wrote about something?
(46:20):
And they give me references that don't even
exist, so I will never ask
LGBT that again unless So how much time
do you write do you spend writing
being, you know, boring?
Oh, yeah. Well,
I would say, on average,
two hours a day.
(46:40):
Okay. And how much researching?
Like, being fun and seeing subjects and doing
MRIs and bending and clustering? Well, see, the
thing is that when we do that, it's,
like,
focused. You know? We might do it for
six weeks. We do fun stuff like that,
and then we write for three months or
something. And then we have to do the
(47:01):
stats, and that's more like
what people think academia is about.
So there's short fun and long maybe not
so fun time.
That's the rewarding part. The not so fun?
How long are you still planning on working
during research?
Well,
I I don't really wanna think about retirement
(47:22):
because I love what I do. But my
husband is kind of wanting to know how
much longer I work because he would like
to travel and go on cruises and stuff.
So I said four more years
is probably it. Which puts you at 50?
35. Oh. Yes.
Okay. So four more years, and then what?
(47:45):
Well, then travel. But
to be honest, I I love teaching, and
I love,
doing research. But in a way, I think
I owe it to the students to give
way to maybe younger folks who have different
ideas.
I don't know whether students necessarily love being
(48:05):
taught by a, in parenthesis,
more than 50 year old person,
you know, because
although I'm a dynamic person
front of them and saying this is how
it's done, how much do this so I
have been teaching I had taught too. How
(48:27):
much do the students actually absorb from what
you say
versus what they what they get from the
Internet? Because
the the the younger generation is born with
a phone between their toes. So
Between the toes?
Alright.
Also excellent question.
I we just started something new at well,
(48:49):
I don't wanna say BYU, but we were
we were told that we could start something
that's called constructivism.
So it's a teaching approach or a learning
approach
that uses
just a different way, not just here, open
your brain and I'm gonna put a lot
of information in there,
but,
talk about tidbits. Like, for example, let's go
(49:11):
back to the disc. Right? This is how
the disc,
gets nutrition,
and this is what happens when you compress
or
distract or and this is this and this
is that. And then the students will put
their own knowledge together
actively.
And we are being told that research has
shown that
(49:32):
this is a much better learning, meaning they
will retain it much better. And I dare
to say, probably much better than when they
look it up on the Internet.
So Wei, Jacques and I, we listened to
something how
AI
has and I didn't quite get it, but
there is AI
consciousness
or AI
something rather. But anyway, they basically say,
(49:55):
if I
might misquote it, so don't get me wrong.
But, somehow, if you do it kind of
what you said in different ways in all
different corners, you don't get just this is
the knowledge, but you can get hands on,
you know the physiology for it, you know
the anatomy, you know the math, you know
the English, and you know the German, and
together, it might come together.
(50:16):
And if they're
if they're doing it through AI,
somehow,
it's supposed to be the pinnacle of being
fantastic. What do you think?
No. I don't think that is
something I agree with. But then, we have
to consider that, really, the people that were
born ten years ago, they had a totally
(50:37):
different upbringing, and and their brain works differently.
So maybe it works for them.
I I don't think so, but I have
been proven wrong before. So for example,
my kids,
they listen to everything in one and a
half or two times the speed. Have you
known anybody like that? Mhmm. To me, it
(50:57):
sounds like
and I'm like, how can you even understand?
And they do understand because I tested them.
What did they say? So their brain is
just a little different.
It evolved, I guess.
And,
maybe AI does a better job than little
me. But until I retire,
(51:19):
I'm not gonna have them tell
or talk to chat GPT
or another AI thing. Before we come to
the last and very important question, do you
have any shout outs you wanna shout out?
Oh, wow. That's a surprise.
Like,
Oh, like my son David and Madeleine and
my daughter Hannah and her husband, Anne. I
(51:41):
didn't know that that was a culture. So,
yes, I would love to send a shout
out to my loving husband who
supported me to coming here
and, of course, my kids and their spouses,
David and Madeline and Hannah and Devon and
my cute, cute
granddaughter,
Winona.
So, yeah, thank you for giving me a
(52:02):
chance. Oh, well, of course. Okay. The any
other little tidbits for little,
knickknacks that you wanna tell about
how to prevent back pain even if you
already have it? Not prevent, but you'll get
rid of it? Possibly besides
sitting on your
arms or not sitting on your arms and
doing the ninety ninety.
(52:23):
I just
want to encourage everybody to be active.
Even maybe initially,
it might hurt more because your muscles say,
wait a minute. I'm not used to this.
Active being active is so rewarding and it
will
most likely prolong your life. Just any activity
is good.
But can I real quick give you one
more little,
(52:43):
tidbit in regards to learning?
There you go to it, and please do.
There is
the saying that Benjamin Franklin gets credited
for. It's tell me and I forget.
Teach me and I remember.
Involve me and I shall learn.
(53:05):
I, a 100%,
believe that that is the best way to
learn, and that's what we're trying to do
with this constructivism
approach. I just don't know where AI has
a place there. But as I said,
that's just my humble opinion.
Okay.
Do you have synesthesia?
(53:27):
Oh.
Yes. I do.
But What is what is it, Etienne?
Well, so my twin sister
has it very much stronger than I do.
So what it is is that two sensations
are coupled that are usually not coupled.
And there are different kinds of synesthesia.
Synesthesia,
however it's pronounced. Yeah.
(53:49):
In our case,
we
associate colors
with numbers.
Hers is very strong. You give her the
number 4, and she says Well, 4 is
not the strongest.
But it would be a yellow.
Well, give me some that you have 24.
(54:09):
As the 24 is Orange.
24 is orange. 24 is orange. 19 is
gray. 17 is light yellow. 99 is black.
66 is brown. Wow. See see, I don't
have it that strong. If I if I
think of a two or a 12, I
think baby blue, to me, that that is
(54:31):
I can see it just floating in front
of my mind. Or number four is also
an orange, but I think yours was 24.
Right? Yeah. And and and we used to
kind of argue.
Like like, I'd say, 12 is baby blue.
And she says, what are you saying? It's
not. It's whatever color it is. Baby blue
is 12. I can see. It's like
16 more, but yeah. Hallelujah.
(54:55):
Alright. So but she also says, what is
white? Hello?
White? Zero? Zero? Yep.
Totally wrong.
White is one.
Zero is zero color.
See through. She said zero is too low
to be white. It has to be one.
Yeah. I give Zero a chance.
Aw. Yeah. That's cute.
(55:17):
Okay. Well,
then we are
almost done. We have now last chance? Last
chance? No? Okay. So we didn't speak because
she just flew in here, so we don't
last chance, you're done? Okay. We have something
called
fun time corner,
where
Jacques tells jokes and I laugh uncontrollably.
(55:39):
I might take her role then. And,
I do quotes. So I don't have any
quotes. I have just dumb jokes. So please
feel free to laugh. I already said two.
So let's go on.
Why do driving instructors make a good physical
therapist?
Because they can teach
(56:00):
fine motor skills.
Need to learn.
A physical therapist commented
that a patient being passionate about the exercise,
this felt like a stretch. Mhmm. So true.
Yeah.
(56:21):
Okay. What did the pinched nerve say to
the patient?
Before physical therapy, I was just a pain
in the neck.
Okay.
I asked one of my physical therapist students
(56:41):
how their classwork was coming along. They said
it was a joint effort.
That works for my class.
K. So here's here's my special joke.
I tell my PT that I try to
jog twice a week.
It's a running joke I have.
(57:03):
Although she does run. Not very funny.
You know
you know you're a good physical therapist when
you turn heads
every day
at work at least.
We do anyway.
We're good people because we turn heads every
day. Darn tootin'.
(57:23):
If you're an anatomist,
that is a polite way of saying that
you're a people watcher.
Oh, she's out of jokes. Why didn't the
anatomy professor tell her students that they dissected
the wrong body?
Ew. That's awful. Because she didn't have the
heart to tell them.
(57:44):
Awful.
We have awful jokes.
What common language is the most popular to
teach anatomy?
Latin?
Body language?
They're so jockey.
Some of them I chose though. Okay. Last
one. I'm not sure why people always say
that that I have bad posture,
(58:07):
but I have a punch.
I have a hunch. Sorry.
You have to do another one. This was
bad to end with. Okay. If you think
about it, nothing begins with the letter n
and ends with the letter g.
She's thinking about it. Hey. You have been
listening to the Doc and Jacques show on
KCLW Doc and Doc. KCLW one hundred point
(58:27):
seven FM in Brookings, Oregon.
We hope you have enjoyed the show as
much as we have.
Thank you, my twin, to my twin, doctor
Rica Mitchell. Thanks also for our sound engineers,
Tom Bozak and Michael Gorse and Linda Bozak
and Holm.
Thank you for listening
and you guys have a wonderful time also
(58:49):
the gang in Missouri.
Bye.
Welcome.
You have now entered the cosmic radio receptors
of KCOW
one hundred point seven FM in Brookings, Oregon.
Thank you for tuning in to this week's
extra
fabulous program.
I'm doctor Gigi, and my cohost is usually
(00:29):
Jacques Kepner,
but he's away for a couple of weeks,
so he won't be here in person,
but certainly in spirit.
And as a matter of fact, I know
he is listening to our show today
in Missouri.
Go Missouri.
So he's having
a listening party.
Hey, Hoppy. Hey, Elizabeth. Is that Purdy?
(00:52):
Doctor Sherry,
Chris Nelson, Darwin,
Pearl, Rebecca,
and of course, lovely Shakhi.
Thanks for listening,
and hello to everybody. So
for this reason, our format for the Doc
and Jacques show is going to be a
little bit different today.
(01:12):
However, as Jockey used to say,
I do want to mention that you are
hearing this live show on KCIAW in Brookings,
Oregon as I said before, but he always
repeats it anyway.
Having said that, the same show will be
rebroadcast
in exactly one week from now each and
every Wednesday on KZZH
(01:33):
ninety six point seven FM in Eureka, Humboldt
at 8AM
in the morning, and then a few hours
later at 1PM at KFUG,
one zero one point one FM in Crescent
City, California.
So as mentioned above, the format is going
to be a little bit different.
And before we start our MD 10 segment,
(01:56):
I want to introduce
our slash my guest today.
I'm not an English major like Jacques is,
so my prologue or introduction
won't be quite as poetic as what you
have heard in the past
out of Jackie's mouth. So
when Jackie and I were thinking about making
this very radio show or
(02:18):
this kind, we subtitled it subtitle it with
ladies first.
We wanted to highlight women who have excelled
in what they're doing best,
especially in a man's world.
One of the first guests that we were
planning on interviewing
is my guest today.
Now, almost exactly two years after starting our
(02:39):
show, we finally got her
here. My guest started her career as a
physical therapist in 1988,
became a certified
manual therapist in 1997,
a board certified orthopedic
clinical specialist,
whatever that means, in 2015.
Meanwhile, she got a master's degree in orthopedic
(03:01):
physical therapy in February
then proceeded to get a PhD
in exercise sciences in 02/2005.
She became a fellow
of the American Academy of the Orthopedic Manual
Physical Therapists in 2016.
She's now a tenured professor in the department
of exercise sciences at Brigham Young University in
(03:21):
Utah.
She was the only female professor in that
department for years, which has, however, since changed.
She has published multiple papers on restless leg
syndrome and low back pain. She has been
invited to speak at several conferences about her
findings and was recognized at the University of
College
and college level for her teaching and mentoring
(03:43):
in 2021
and again in 2025.
Wow. So you wouldn't think this is a
talk show. So, anyway, she also happens to
be my twin sister.
Therefore,
as Jacques likes to say without any further
verbiage from
me, I want to introduce
doctor
Rike Mitchell.
(04:04):
Welcome to the Doc and Doc Show, which
for today, we will rename
to the Doc and Doc Show. Welcome.
Thank you. Thank you for having me on
the Doc and Doc Show.
I came all the way from Utah to
be here with quite some stress, so you
can tell how excited I am about this
opportunity.
Right. So as a matter of fact, we
didn't even have time to talk. She flew
(04:26):
into Medford,
drove down, had to wait at the Jedediah
Smith's Park for some sort anyway. We did
not meet up till
just now before the show.
So but she's here.
So let's proceed
with our MD 10 or MD PhD 10,
I should say. Today, we're gonna be talking,
(04:48):
about
physical therapy
and how it helps with the healing.
Because, you know, she's a physical therapist.
Most commonly known is the physical therapy is
the fact that it restores
some kind of range of motion. Right? Physical
therapists use the techniques like stretching and joint
(05:08):
mobilization to prevent stiffness
or an excess scar tissue formation
to keep the joints
flexible.
But it also is used to rebuild
strength.
So they have those so called targeted exercise
that strengthen
certain
weakened muscle, which of course is crucial for
(05:30):
regaining
function and stability.
So
where I work for example,
we do see patients for deconditioning
after a bout of seborosepsis
or
other
occasions where they need to rebuild
strength.
If I think about physical therapy, I usually
think about the rebuilding of strength. What do
(05:52):
you say? Yeah. So rebuilding strength is an
important factor in PT. But if you think
about it, you could also go to the
gym if it's all about the gym, the
strength. Yeah. So in physical therapy, we also
try to improve functionality
of a person. So we're working on functional
strength,
balance, independence,
and movement dysfunctions. And actually, physical therapists are
(06:15):
considered to be the movement specialists.
Oh, wow.
Well,
let's move on to other things. Physical therapy
can also
prepare for treatments.
Patient can use physical therapy to build strength
and maintain function before
cancer treatment begins,
helping them to tolerate aggressive
(06:37):
therapies better.
We do send patients to physical therapy before
hip surgery, for example.
This is pretty,
new. It's called pre habilitation.
And we,
strengthen. We put people on strengthening program before
surgery. So,
we we teach them exercises that they will
(07:00):
have to know right after surgery when they're
more confused. So we teach them when they're
not confused, and we teach them about what
they can expect to happen.
So I think prehab is a big part
of successful physical therapy.
Yeah. Yeah. We send them all the time.
Not for every joint change, but hip. Right?
Is that the most important part? Hip and
knee. Hip and knee. Mhmm. Physical therapy also
(07:24):
improves circulation.
So exercise and movement enhances
blood flow
to the vital organs and non vital organs,
I'm sure, and the injured areas, which promotes
then faster and more complete healing.
Yeah. This is the part of therapy that's
off that does not often get talked about,
but it is so important to healing.
(07:46):
Could be after surgery, after a stroke, or
any other immobilizing
injury.
Circulation is, of course, always important, but even
more so if you need to get oxygen
to the injured side, like you said. A
lot of people are afraid of moving after
surgery or after they had a problem. Yeah.
And so it's it's it's really important for
(08:06):
us to tell them that
pain is not always
a warning sign. It might just be a
sign for the,
tissue being,
maybe
aggravated, but there it's important for healing, and
it won't make the injury worse.
But you always have to ask the doctor,
(08:27):
and he or she will know what to
do. But chances that the doctor will want
you to move to provoke to promote healings
are big.
Wow. Cool. Alright.
So there are other specialties in physical
therapy. So for example,
we have
physical therapy that helps cancer patients.
(08:50):
That's right. So
one, of course, is the regaining strength coordination
with cancer people who get chemotherapy and then
they're tired and then they're everything is sapped
out of their body because
of the chemotherapy.
Mhmm. Then it reduces
pain and fatigue
(09:10):
by helping them to move around
a way that they can manage without actually
getting exhausted.
And it can manage
side effects.
So
Let me just real quick talk about the
speciality
of oncology physical therapy because that's that's actually
relatively new. The first certification was in 2019.
(09:33):
So if you think about it, it was
six years ago. Ago. And they started with
the process in 2016
when they said, okay, there should be a
special specialty,
in oncology, and then they had to make
sure that the test questions were set and
all that stuff. Oh, very
cool. Yeah.
So some other,
side effects in the oncology is actually the
(09:55):
lymphedema. You can have lymphedema without having cancer,
but especially breast cancer when you take lymph
nodes out, a lot
of people are left with lymphedema, very
waterlogged
arms or limbs. So,
I have sent people
for physical therapy for lymphedema
and
(10:16):
most likely because it wasn't a very known
subject at that time,
they had to travel or they had to
find somebody who was actually certified for that.
It's most likely
super important, I think, because lymphedema is very,
functioning limiting.
Yep. So especially in breast cancer patients or
(10:37):
post mastectomy,
there's a lot of lymphedema in the upper
extremity in one or both arms, and people
lose functionality
because there's just so much fluid in their
arms. And lymph edema
I mean,
lymph drainage, which is the
skilled massage technique for lymphedema,
(10:58):
takes
quite a bit of education
and,
practice.
And,
it's kind of like a specialty within physical
therapy as well, but it can be very,
very beneficial.
Wow. Now you can also have physical therapy
for neuropathy.
So you have some nerve damage leading to
(11:19):
pain or decreased sensation,
which is which is treated with specialized exercises.
What
what to explain nerve gliding,
etcetera.
Yes. Please point this up.
So I worked a lot with people with
neuropathy.
Let me just step back. So neuropathy is
(11:39):
when people lose their feelings.
Could be because of, cancer treatment, but it
could be because of diabetes. I actually think
that I have seen that much more,
that they have decreased,
sensation in their the soles of their feet.
And they don't notice that
maybe they injured the sole and there's might
be some some opening or a wound.
(12:01):
And because they have neuropathy, there's decreased blood
flow to that area. So this area might
get infected and people don't even know about
it. So this decreased circulation to the skin
that comes with neuropathy
is really a double whammy. First, you don't
feel when you injure yourself and then it,
inhibits the healing process. Yeah.
(12:22):
Darn. Okay.
Any other little
excursions?
Yeah. I have a couple more, like, why
we do PT for cancer patients.
And usually, it's to to treat the side
effects like you said. I just wanted to
maybe go into detail. The pain and fatigue
are the worst side effects from cancer treatments.
(12:45):
And,
therapists can't take that away, but we provide
education and techniques to manage
discomfort
and maybe explain or show them some exercises
that reduces the debilitating effects of the fatigue.
And then, like earlier, we help them with,
increased function.
(13:05):
And if,
there's balance problems due to cancer treatment or
neuropathy, then we help with balance training. Alright.
How do you do balance training? Have them
hop on one leg? Well, that would be
for later on, but we have these,
I don't know, three inch cushions,
and we have them stand on it and
(13:26):
just retrain,
the proprioceptors
that are in the ankles. These are, like,
sensors that tell the brain you're standing awkward
or you have too much sway or something
like that. Well, cool. Alright. Thank you. That
was a nice little excursion into physical therapy
and some of its application as far as
I can handle on my side.
You are now warmed up to hear more
(13:48):
about physical therapy and findings and experiments and
results and research
by a professional.
But before
we get into all of it, let's delve
into getting the skinny from my guest today,
Horika Mitchell.
So
here are the questions.
Where were you born and raised?
(14:08):
This was a tough one for me because
it's the same one as Gigi. So we
were both born in Castorpruxel,
which is in Germany.
And we were also both raised in the
Black Forest. When we were about one year
old, we moved to the Black Forest in
heavens,
and we stayed there until
we were older.
(14:32):
Okay.
Well, so and then
we go on
when we got older. Is that how you
ended up? That's when we got older. I
didn't wanna say old because we're still not
old. So so the first pathway that I
happen to know,
because you're my sister, the first pathway to
college was to become a French and physical
(14:53):
education teacher for high school.
You even lived in France for a little
bit. What changed your mind?
So like so many people in Germany at
that time,
I wanted to become a teacher because you
got six weeks of vacation and you got
really good pay. It's not really the same
situation here in The States. You don't really
get paid that much.
(15:15):
And, our older sister, Berble,
she also
was going to be a teacher. And by
the time she graduated, she's five years older,
so she graduated about five years before
us,
she was on the street, basically, because there
were no jobs available as a teacher because
everybody wanted to do it. Yeah. So, basically,
that was my wake up call. And I
(15:35):
thought, what else am I gonna do?
And,
I thought
physical therapy would be great. I really didn't
really know what physical therapy was. I just
received it one time for my shoulder. I'm
like, that would be cool. So I applied.
So how long does it take in Germany
to become a physical therapist? Well, when it
was my turn, it just took two years.
(15:57):
But things have changed. And keep in mind,
it was, let's just say thirty ish years
ago, maybe more like forty,
almost thirty,
that,
that I went to school. So at that
time, it was two years, and I believe
now you can actually get a bachelor's degree
in physical therapy, and that's, of course, more
(16:18):
like a four year education.
Yeah. So did you ever work as a
physical therapist in Germany? I did for about
two years.
Okay. That must have been fantastic since that's
all you say.
When did you move to The States?
Well,
I
visited The States for about a year after
(16:39):
my PT school was done because what is
now called a gap year, I didn't know
that then, I was just I didn't really
wanna go to work full time because that
meant the rest of my life was prescribed.
So I went to The States and teach
to teach German and French at a couple
of schools.
So Marietta, Georgia. Yeah. Marietta, Georgia. Yeah. Marietta,
Georgia. Yeah. And I couldn't afford it. Yeah.
(17:00):
It was pretty fun. And so when I
came back to Germany,
I missed speaking English, and I went to
an American church, and I met my future
husband there. And
after we got married,
we came to The States.
And I've been there ever since. Yeah. What
(17:21):
happened next education wise? And especially, why did
you keep going further and further to get
this and that and all these numbers and
thingies behind your word behind your The letters.
Letters and this.
So I I think education is
exhilarating. I love getting
more skilled or or know more academically,
(17:43):
and I just have fun studying and learning.
So, again, I came over with a bachelor's
equivalent degree in, in physical therapy. But about
that time, all the PT programs in The
States, they transitioned
from
bachelor's to a master's degree,
and they offered bridging programs for those who
had a bachelor's and wanted to become a
(18:04):
master. So I enrolled in one of those,
and five years later, I got,
an MS in orthopedic manual therapy.
And later on, those programs shifted again, and
right now, you get a doctor of physical
therapy, like a DPT.
And I considered pursuing that, but a wise
friend
(18:25):
advised me to go for a PhD instead.
So just for the listeners, a DPT, a
doctor in physical therapy, is a clinical degree
and a PhD
is an academic degree.
And as such, I'm involved in research. And,
I I love academia and I love research,
but I still love the clinical side. So
(18:47):
I treat patients still, and I advanced my
training in manual physical therapy,
and I became a certified orthopedic PT, and
then I became a fellow like Gundy said
earlier.
So I just always try and continue to
to learn and study and get better.
Okay. So let's say you are,
(19:10):
working. So what does a normal day at
the university look like for you?
So this is really funny. I am busy
all day. And when I asked a professor
at BYU where I was before I started,
I asked him, what do you do all
day? And he said, oh, it's just always
busy. I do research and meet with students.
I'm like,
how busy can that be?
(19:30):
So
but I am so busy. I'm I spend
a lot of time preparing and teaching classes.
I teach two classes a semester.
I meet with students about their coursework and
research. I collaborate with colleagues on teaching
and research projects.
I'm the graduate coordinator, so I work closely
with graduate students and their mentors.
(19:51):
Right now, for example, we are revising the
PhD comprehensive
exam to better align with the BYU aims.
And then lastly, I'm also the faculty
liaison
for the PTOT,
which is occupational therapy club, which means I
regularly meet with students involved in that group.
And when the teaching, advising, and meetings are
(20:13):
done, I finally get to dive into research,
which I really love. I collect data. I
write and explore the latest
literature.
Okay. Though, also, you teach two classes this
semester, what classes do you teach? So this
year, I teach orthopedic
impairment,
(20:34):
which is a class that focuses on joint
problems, including the spine. We talk about scoliosis
and how to design exercises to help treat
them.
And then I teach, but not this semester,
advanced musculoskeletal
anatomy where students learn more than just the
fundamentals.
We learn terminology,
bones, nerves, muscles, and ligaments.
(20:57):
And at the graduate level, I teach in
extremity mobilization
where students practice techniques to mobilize the joints
of the arms and the legs as well
as, get this,
the larger nerves. We mobilize the nerves, which
you earlier mentioned, that's nerve gliding.
Oh. And then, lastly,
I just started teaching a brand new class
(21:19):
that's unique to BYU, and it's called University
one zero one, foundations for student success.
Yeah. It's kind of fun. What is it?
Has nothing to do with physical therapy. No.
No. No. It's like I we get all
the freshmen. There's, like, two hundred and fifty
secondtions offered to catch all the freshmen, and
we wanna make sure that they have friends
throughout the time because there's so many students
(21:41):
that graduate and they never had a friend.
They never had a a peer that they
hung out with. So we do a lot
of,
get to get to know each other. They
talk about the idea behind BYU, and and
it's just a really fun,
in parenthesis, a lot of work for me,
class for the students.
Okay. So you said you teach orthopedic
(22:02):
impairment or exercise or something. Wouldn't that be
something fun for people,
you know, people who have that, not just
for the students? Can you go and do
a service and teach go to a hospital
and say Yep. Well, I could.
But
but, I need to free time, I mean.
I was just gonna say that, I was
asked once to talk at, in our gerontology
(22:25):
department about those things. So if I get
asked, or there was a university wide, it's
called Well and Wise, and I talk about
how to take care of your back. So
I do. I just I don't look for
those opportunities,
but maybe I could. Well, you'll have some
pearls for us later on in right now.
I do. I'm excited. Take that away.
(22:46):
Do you have graduate and undergraduate students? Yeah.
Right now, I have two master's students.
One is in her second year, so she'll
be graduating in a year, and one that
just started. And then I have seven undergrad
students that
help me with my research or I mentor
them.
How to do research? Is that what you're
mentoring them? Yes. Do they get paid? Yes.
(23:08):
Woah.
Dang. Okay. So
tell us about your research. What do you
research?
So I probably won't shut up. So you
have to tell me when you're done. In
three minutes I mean, in seven minutes, I
have to do the mid breaks.
Okay. So my current research focuses on chronic
low back pain. More specifically, I'm studying pain
(23:30):
that comes from the interretibial
disc.
A healthier disc is typically
more hydrated. It has more water. So one
part of my studies
are exploring ways to improve disc hydration as
a potential treatment.
If we could figure out how we can
increase the water content in the disc, I
think we can keep it healthier longer. Drinking
(23:50):
water.
Yeah. That's what students ask me a lot.
Is it helpful? I'm like, yeah. I mean,
you shouldn't
be dehydrated,
but I don't know whether more water will
pump more more water to the disc. But,
I mean, nobody has done that research because
I looked at it.
I wanna be co author.
So I'm also collaborating with colleagues in the
(24:12):
mechanical engineering department to study how people with
chronic low back pain move.
We're trying to find clusters of movement patterns
that maybe we can use to
design treatment options for. Once a pain has
moved on to chronicity,
the brain has changed. The synapsing changes. There's
(24:35):
just this big overlap. Synapsing?
Like,
connecting.
Information
from nerve to muscle? Yeah. Yeah. Yeah.
So so that has changed. Plus, there is
this
psychosocial
overlap, meaning psychology and the social environment
just changes when you have chronic pain. So
(24:56):
we're trying to find out if we can
find movement clusters. We call it phenotyping.
Maybe,
let's say, we have seven phenotypes, and we
can treat these different phenotypes differently and get
them better. So seven different ways of how
people describe their lower back pain? Well, we
have we actually have the move.
(25:16):
So the engineering department has developed these sensors.
So we have a move, and some move,
always
slower into into forward bending, or they don't
like to twist or something like that. It
has to do with speed and their range
of motion, how far they go, and we're
hoping to find these clusters
that we then treat. Because by the time
(25:37):
a pain has moved into chronicity, it's super
hard to find the origin or the etiology.
And once you find it, it might not
even be there anymore because you have that
psychological
overlap.
So okay. So you find some you find
your clusters, seven clusters, seven ways It must
be five.
Of how people move when they have certain
(25:59):
back pains.
So then what? I mean, how do you
help them? Well,
in theory, we Yeah. In theory. We're not
there yet.
But in theory, we think if they have,
like, they don't reach forward as much as
normal people do, then we would maybe do
mobilization
or range of motion
into
flexion. Right? What they're impaired and not worry
(26:20):
about the cause, just what are they impaired
in. And
and our assumption is when they move like,
quote unquote, normal people do, those without chronic
low back pain, we might have helped them
with the pain as well.
Okay. How's that been done yet? I mean,
does that research come from an origin saying,
hey. This person who always stooped over a
(26:40):
little weirdly and now we tell him how
to stoop, otherwise he has no more back
pain?
No. That's why we're in this life.
We're trying to find whether that works. Nobody
has done the phenotyping.
Oh. Because everybody's trying to find the origin.
But by the time Yeah. Yeah. Oh, okay.
So that's the newest approach. Because for back
pain, when you have, I don't know, whatever
(27:01):
the x-ray says or the MRI says, then
I said, okay. We'll send you to physical
therapy if the, you know, the neurosurge is
not indicated, and we hope that the physical
therapies know what to do. You know what?
This brings up a fantastic point.
We get a lot of people that have
and come back with the MRI and say,
the MRI says I have this and this.
Well, guess what? The MRI picks up everything.
(27:22):
We call it it's very sensitive.
So it picks up everything even if the
pain doesn't even come from that. I might
have a herniated disc, for example, but I
have no pain. Yeah. Somebody else might not
have something that is shown on MRI Right.
And they have pain. So
Right. So we're trying to just take that
out and just do the movement clusters. Okay.
But so so far, somebody has scoliosis.
(27:44):
Let's pretend I know it's not the real
treatment, but let's just pretend scoliosis
goes to,
physical therapy. We just send anybody, doesn't matter
what the degrees
are, are to physical therapy.
How are the physical therapists
educated in knowing, well, this is really the
wrong we don't or or you have to
do whatever what cluster one does and not
(28:05):
cluster
two. Do they know? How do they get
the training? Well, if they come because they
have scoliosis, it's not chronic low back pain
or, you know so I'm That was an
example. I know. For the list of leases
or whatever, nobody knows when talking. No. I
I was just trying to understand what you
were saying. So I don't know whether I
understood correctly, but we don't care why somebody
(28:27):
has chronic low back pain, if it's scoliosis
or whatever big word.
We would we think
that once it's chronic, they just need a
certain treatment. We just don't know which one,
so we're thinking about the movement pattern. That's
not what you were asking, No. I'm asking
yeah. So that's kinda like I'm asking. Right
now, the phys the physical therapist, you have
(28:48):
this diagnosis, so you do this treatment. Right?
I mean, that's how it is now. So
you're trying to actually
go a little bit deeper and then
the physical therapist still have to be trained
for that. Yeah. You're right. I'm sorry. I
misunderstood.
Yes. Right now, you come with scoliosis and
you should do certain things that Yeah. Almost
prescribed. Right? Yeah. Yeah. That's what I thought.
(29:08):
Mhmm. Well, but guess what?
We are halfway done already.
So time flies when you have fun. It's
that mid break time at the Doc and
Doc Life radio show. Okay. Doc and Doc
in real life.
And we are proudly broadcasting from the KCIW
one hundred point seven FM
studio in lovely coastal Brookings, Oregon, and I
(29:32):
wanna
list the major sponsors
for our community radio station.
We have Advanced Airlines,
which is flying in and out nearby Crescent
City to Oakland and Los Angeles seven days
a week. Michelle Buford with our own vibrant
local Curry County Chamber of Commerce.
Nick and Lisa Rail, Anthem PPA, the Partnership
(29:56):
for the Performing Arts,
remembering the
no. Don't remember anything. The medical team at
the Checo Medical and Aesthetic in Harper where
I happen to work.
And,
yeah, me and Jackie, we are the sponsors.
On case on behalf of KCOW,
thank you
all of us. So let's go back to
(30:19):
our guest here, doctor Rica Mitchell, my twin
sister,
who is a physical therapist
exploding into PhD and whatnot. So, you have
to scale back and find out all what
she has done. We're talking about her research
in
low back pain, and I think I start
to understand what the research is for. It's
(30:39):
for the future. It's for the next generation
who then knows how to treat the different
clusters.
Unless you have anything else to say, I
wanna ask, how do you do research?
So first, you have to find a field
that you're passionate about. For me, it was
low back pain or chronic low back pain,
(31:00):
and I even was interested in that as
a physical therapist.
Then
you dive into the literature and read everything
you can find. You will find thousands
of papers, so you have to not narrow
it down. For example, I narrowed it down
because I came in became interested in
why do intervertebral
discs dry out.
(31:22):
I tried the increased water intake. That didn't
feel like Go, go, go, go. So then
I thought it was part of aging, so
I'm thinking there must be a way to
slow the process.
And just just so maybe the listeners can
appreciate, it's a super
interesting
subject.
I wanna explain real quick how a disc
(31:43):
works. It's kind of like a sponge.
Compression, when you push on it, that pushes
the fluid and way waste products out, which
is good. And when you pull on it
or let it sit there without pressure on
it,
then it sucks up the fresh nutrients and
water.
Yes. Exactly like that. So that let me
(32:05):
wonder,
could certain physical therapy techniques improve
this hydration?
And when I looked at the literature, I
realized nobody
has worried about that. Again, that's why I'm
in this life.
There was a research gap, and filling those
gaps is how new knowledge gets created. Yeah.
So sometimes, though so I was just wondering.
(32:27):
Right? And I made my own thoughts, and
and I found a gap. But sometimes, it
starts with a new hypothesis.
For example,
in my case, I wondered,
when you run, you have with every step,
you kind of squish water out of the
disc. And then when you're in the air,
ever so slightly,
there is some
(32:48):
distraction
on the disc and it can suck up
the fluid like you just said. So I
thought,
is running good for low back pain, chronic
low back pain? And keep in mind, not
if you have a fracture or if you
know exactly what what's going on. I'm talking
about the disc is the culprit. Right?
So we did And not protruding and pushing
(33:09):
on the spinal cord. Right. Just
a degenerated bit. Degenerated,
the wear and tear.
So,
basically, the essence of research is you ask
questions,
find gaps in what's known, and then you
design careful studies to fill those gaps.
Okay.
For example?
(33:30):
Well, since I talked about the running, we
did this study where we
invited 40 people with chronic low back pain
to our study. 20
were put on a running program, and 20
just did whatever they did before,
which was not running.
And we found out that,
(33:52):
most of them so statistically,
significantly,
amount of people
had decreased pain
after the running program.
And and we also found out, as an
FYI,
that
people
are afraid of running. They don't think I
hate running or I'm lazy. They're afraid that
it makes it worse because they're being told
(34:13):
from neighbors or something,
somebody that it's bad for you. So they
thought, well, I'll try it because, you know
Well, isn't it? It's not. Well, it depends.
If you have a fracture, obviously, it's bad.
But if it's just a degenerated disc, which
usually or often chronic low back pain comes
from, then it's actually a good thing to
do. Hey, Shnole.
(34:34):
Yeah.
Okay. What is a physical therapist's favorite coffee?
Oh, I know that one.
Tinto Face Latte.
Nice. Okay. Continue.
That was my plucky intermission.
Go ahead with your low back pain stuff.
Yeah. We're good. That was that was a
(34:54):
good finding with the with the running and
it being good. Okay.
So,
what can one do now that we have
our low back pain because we have gone
we have been around the block a couple
of times.
So we don't really wanna be running anymore
because
running
that has shipped that has, you know, that
ship has sailed. We're already older. So what
(35:16):
can we do?
So you don't have to necessarily be running.
And and I should have been more clear.
It was a running slash jogging slash walking
program. Yeah. I like the walking. There,
like, the participants were told every week how
far did you go, and then let's add
something,
to the distance. They might have just gone
twenty second at a time and walked for
(35:37):
two minutes, so the next week they maybe
ran twenty five seconds or so. It was
slowly increasing
in magnitude,
but still, you know, it helped. But for
those who have chronic low back pain, any
movement is good. It's good for so many
reasons, cardiovascularly.
Right? I mean, if you bring your heart
rate up, cardiovascularly, that will
(35:58):
help. And,
chronic low back pain will,
not want to be a couch potato, so
you need to get off
the couch or off the chair and just
move around.
Backs want to be moved for the reasons
I explained. You know? It wants to be
squished, and
it wants to be in a situation where
it can Yeah. Yeah. Free floating in the
(36:20):
air.
I like that. Yes.
Okay. So it happens too that you don't
just do the talking, you also do the
walking.
You're known to have run marathons,
many of them. Is that still something you
do?
No. I ran 20, which was a goodly
amount. A goodly?
(36:42):
Yes. But, no, I don't run anymore because
my knees
have vetoed that sport big time. But I
still stay active. I try and do at
least an hour of cardio every day, which
I won't get to do today because I've
been
sitting down since 7AM to get here. Because
she flew in here, and then she was
in the car.
But I We'll be at the beach later.
(37:04):
Yeah. Yeah. But I lift weights from time
to time. I personally don't like it, but
I know how important it is because our
bone density goes down with age. So lifting
weights is it doesn't have to be tons
and tons of weight, just
some poundage that will benefit the bone strength.
Yeah.
(37:24):
So you told us about how to design
the the test, like, you know, frolicking
in
frolicking in the air.
And I was thinking about
any other
fun
stories that you can enlighten our hearts with
while designing a research.
(37:45):
I I really have a funny story to
tell. Actually, I I thought it was funny.
Maybe you guys don't think it is.
But,
a few years ago, I wanted to study,
very apropos,
whether the intermedieval disc
absorbs water when placed under traction.
And because that was known then. And I
(38:05):
wanted to put the person
in in the MRI, take an MRI
before, and then while in the tube, put
weights
on the person.
So To stretch them. To yeah. To stretch.
Yeah. Now you probably all know that you
can't bring ferromagnetic
materials in. So anything like, metal,
(38:26):
you can't bring in. So my then PhD
student and I decided to get creative. We
built, like, a scaffolding, like, a traction scaffolding
using PVC pipes
around the MRI tube,
and we wanted to hang about 20 pounds
of water weights using milk jugs filled with
water.
So we did that, and we thought it
(38:48):
was just the best idea when the whole
scaffolding
scaffolding
collapsed
in the MRI
room.
So we had to we are not engineers,
so,
we had to redesign this whole thing. But
it did work, and it was a great
study. And I did show that traction increase,
(39:08):
water hydration in the discs. So what do
we do with that knowledge?
Yeah. That's a good idea.
I mean, it's a good thought. I I
tell you what I do.
At any time I can, I push off
a seat, for example, like the arm rest?
And I push off that my bum is
kind of in the air. It doesn't have
(39:30):
to be that high, but, you know, you
take the pressure off of your bum when
you push up. Mhmm. And and when you
listen carefully, which I always do,
you do hear the discs make the sound.
Because
they do
take in the water. We call it imbibe
(39:52):
the water. They they do some imbibition, which
means that
new water nutrients come in. And then when
you let go, you feel the water come
out again. And if you think about it,
after you go for a long walk or
if you,
run, then you are actually shorter after that
exercise. And you're also shorter at the end
of the day if you sit or walk
(40:13):
a lot because the fluid within your discs
gets squished out. So you wanna make sure
that during the day, you can get it
absorbed again. So this is a good exercise.
And so how long do you hold it
up there? So I can't, but preferably would
be two minutes. Two minutes has been shown
to make you get the biggest bang for
your buck. But if you do if you
(40:34):
do, like, ten seconds at a time, just
do it when you have to sit all
day. It's very beneficial.
But I have another one too. Oh. So
when you gray tail.
You lie down on your back and you
bend at your hips and your knees about
90 degrees. It's the ninety ninety position.
And then you put your feet on
(40:55):
a cushion or something and push ever so
slightly with the feet down.
That kind of lifts up your bum too,
but it also elongates
the the spine.
So in that position, you don't have gravity
pulling down, but so it's gravity eliminated
almost, and it has time and
hopefully enough fluid to get
(41:19):
dehydrated. But you have to listen carefully.
Okay. So what about
the inversion thing, inversion chair? Oh, so I
have an inversion
table. Table.
So what it is is it's like a
board that you strap
you you stand at it,
you strap your legs in, your feet, and
(41:41):
then it tilts backwards.
So theoretically up to a 180
degrees down, like, perpendicular to the ground, but
you don't have to be that much inverted.
You can be like All the blood is
in the head then. Yeah. The I mean,
and and especially in the beginning, you you
might not like it. But I've done it
for so many years. I love doing it.
So you go down to if 90 is
(42:03):
horizontal, maybe a 120
degrees or so,
and just sit there. And I tell myself,
because research has shown it, two minutes is
enough. But start slowly. You don't wanna have
a stroke because you have to I know.
When the eyes pop out, maybe that was
too long.
Pick them up, put them back in, and
then don't do it that long anymore. Yeah.
(42:26):
So
the research sounds
fun. Who pays for it?
Yeah. So I'm super lucky.
Our department pays a lot for it. We
can just ask for an internal grant, and
we usually get it granted.
If if
the chances that the paper gets published are
great. But, I mean, you don't get tens
(42:47):
and tens of thousands of dollars. I mean,
a couple thousand to pay for subjects, for
example.
And then I'm super blessed because we can
use
we have an MRI at BYU,
and we pay a couple $100 per hour,
for example, to use it for research.
It's not meant to be a clinical device,
but for research,
(43:07):
we can use it. And we get
$5,000
a month to use it for free. Dang.
I should have done that. I came down
there and then something happened. Why did I
not get that MRI?
I think we wanted to do a DEXA.
Or or may I may that.
Do you have a DEXA? Yeah. We do
have a DEXA scan for? So the DEXA,
tells you bone density,
(43:30):
and and it it's, like, super fast. Whole
body scan takes, like, fourteen minutes or so.
Super fast. Okay. Well, it's actually seven minutes,
but then you also do the extra bone
stuff like the spine and the hip. So
and that's, like, the whole package.
And, it tells you bone density of the
hips and the spine because that's usually where
you have the fractures. Like, you fall and
(43:51):
you break your hip. Or
interestingly,
often, you break your hip and that's why
you fall because your bones are so brittle.
So we have that scan. It can also
tell you, like,
body fat
percentage
and lean tissue,
stuff like that.
All the important stuff to start losing weight.
(44:12):
So let's go back to the more oh,
wait. I first wanna do a joke. What
did the physical therapist say to the bodybuilder
with a herniated disc?
You don't know squat.
These are these are Jackie,
type.
Jack Jack.
What advice would you give the younger generation
(44:33):
that are pondering going to
the academia?
Yeah. So I'm obviously a fan. So I
would tell them, if you enjoy research, then
absolutely go for it. It can be a
blast. It's awesome.
An academic career is is so rewarding as
well for me. And you get to explore
new ideas. You get to mentor students.
(44:55):
And
in many ways, I think their energy
is what keeps me young,
miss younger than
my sis
I work with older people.
What?
So
often students ask me, I don't really like
to do research, but I love teaching. Should
(45:16):
I go? Should I get my PhD? And
I'm like, I don't think so because really
PhD is
is really about research.
So
so I don't tell them not to do
it, but I'm more cautious there.
Because the academic route is almost
always
research involving.
And research does not just,
(45:37):
you know, translate into milk cartons and PVC
thingies.
It means
writing papers and looking up stuff. Although, chat
GPT would all make that research much easier
now. But writing and writing. Oh, how do
you write? Do you write your own stuff?
I absolutely write my own stuff. Plus, I've
been writing for twenty well, for
(45:59):
eighteen years. So JACOBD
wasn't really invented then.
JACOBD
has its place, but I don't know whether
it can fully write a paper and be
trustworthy.
I have asked it before, can you give
me some, citations
or, you know,
some some ideas of who wrote about something?
(46:20):
And they give me references that don't even
exist, so I will never ask
LGBT that again unless So how much time
do you write do you spend writing
being, you know, boring?
Oh, yeah. Well,
I would say, on average,
two hours a day.
(46:40):
Okay. And how much researching?
Like, being fun and seeing subjects and doing
MRIs and bending and clustering? Well, see, the
thing is that when we do that, it's,
like,
focused. You know? We might do it for
six weeks. We do fun stuff like that,
and then we write for three months or
something. And then we have to do the
(47:01):
stats, and that's more like
what people think academia is about.
So there's short fun and long maybe not
so fun time.
That's the rewarding part. The not so fun?
How long are you still planning on working
during research?
Well,
I I don't really wanna think about retirement
(47:22):
because I love what I do. But my
husband is kind of wanting to know how
much longer I work because he would like
to travel and go on cruises and stuff.
So I said four more years
is probably it. Which puts you at 50?
35. Oh. Yes.
Okay. So four more years, and then what?
(47:45):
Well, then travel. But
to be honest, I I love teaching, and
I love,
doing research. But in a way, I think
I owe it to the students to give
way to maybe younger folks who have different
ideas.
I don't know whether students necessarily love being
(48:05):
taught by a, in parenthesis,
more than 50 year old person,
you know, because
although I'm a dynamic person
front of them and saying this is how
it's done, how much do this so I
have been teaching I had taught too. How
(48:27):
much do the students actually absorb from what
you say
versus what they what they get from the
Internet? Because
the the the younger generation is born with
a phone between their toes. So
Between the toes?
Alright.
Also excellent question.
I we just started something new at well,
(48:49):
I don't wanna say BYU, but we were
we were told that we could start something
that's called constructivism.
So it's a teaching approach or a learning
approach
that uses
just a different way, not just here, open
your brain and I'm gonna put a lot
of information in there,
but,
talk about tidbits. Like, for example, let's go
(49:11):
back to the disc. Right? This is how
the disc,
gets nutrition,
and this is what happens when you compress
or
distract or and this is this and this
is that. And then the students will put
their own knowledge together
actively.
And we are being told that research has
shown that
(49:32):
this is a much better learning, meaning they
will retain it much better. And I dare
to say, probably much better than when they
look it up on the Internet.
So Wei, Jacques and I, we listened to
something how
AI
has and I didn't quite get it, but
there is AI
consciousness
or AI
something rather. But anyway, they basically say,
(49:55):
if I
might misquote it, so don't get me wrong.
But, somehow, if you do it kind of
what you said in different ways in all
different corners, you don't get just this is
the knowledge, but you can get hands on,
you know the physiology for it, you know
the anatomy, you know the math, you know
the English, and you know the German, and
together, it might come together.
(50:16):
And if they're
if they're doing it through AI,
somehow,
it's supposed to be the pinnacle of being
fantastic. What do you think?
No. I don't think that is
something I agree with. But then, we have
to consider that, really, the people that were
born ten years ago, they had a totally
(50:37):
different upbringing, and and their brain works differently.
So maybe it works for them.
I I don't think so, but I have
been proven wrong before. So for example,
my kids,
they listen to everything in one and a
half or two times the speed. Have you
known anybody like that? Mhmm. To me, it
(50:57):
sounds like
and I'm like, how can you even understand?
And they do understand because I tested them.
What did they say? So their brain is
just a little different.
It evolved, I guess.
And,
maybe AI does a better job than little
me. But until I retire,
(51:19):
I'm not gonna have them tell
or talk to chat GPT
or another AI thing. Before we come to
the last and very important question, do you
have any shout outs you wanna shout out?
Oh, wow. That's a surprise.
Like,
Oh, like my son David and Madeleine and
my daughter Hannah and her husband, Anne. I
(51:41):
didn't know that that was a culture. So,
yes, I would love to send a shout
out to my loving husband who
supported me to coming here
and, of course, my kids and their spouses,
David and Madeline and Hannah and Devon and
my cute, cute
granddaughter,
Winona.
So, yeah, thank you for giving me a
(52:02):
chance. Oh, well, of course. Okay. The any
other little tidbits for little,
knickknacks that you wanna tell about
how to prevent back pain even if you
already have it? Not prevent, but you'll get
rid of it? Possibly besides
sitting on your
arms or not sitting on your arms and
doing the ninety ninety.
(52:23):
I just
want to encourage everybody to be active.
Even maybe initially,
it might hurt more because your muscles say,
wait a minute. I'm not used to this.
Active being active is so rewarding and it
will
most likely prolong your life. Just any activity
is good.
But can I real quick give you one
more little,
(52:43):
tidbit in regards to learning?
There you go to it, and please do.
There is
the saying that Benjamin Franklin gets credited
for. It's tell me and I forget.
Teach me and I remember.
Involve me and I shall learn.
(53:05):
I, a 100%,
believe that that is the best way to
learn, and that's what we're trying to do
with this constructivism
approach. I just don't know where AI has
a place there. But as I said,
that's just my humble opinion.
Okay.
Do you have synesthesia?
(53:27):
Oh.
Yes. I do.
But What is what is it, Etienne?
Well, so my twin sister
has it very much stronger than I do.
So what it is is that two sensations
are coupled that are usually not coupled.
And there are different kinds of synesthesia.
Synesthesia,
however it's pronounced. Yeah.
(53:49):
In our case,
we
associate colors
with numbers.
Hers is very strong. You give her the
number 4, and she says Well, 4 is
not the strongest.
But it would be a yellow.
Well, give me some that you have 24.
(54:09):
As the 24 is Orange.
24 is orange. 24 is orange. 19 is
gray. 17 is light yellow. 99 is black.
66 is brown. Wow. See see, I don't
have it that strong. If I if I
think of a two or a 12, I
think baby blue, to me, that that is
(54:31):
I can see it just floating in front
of my mind. Or number four is also
an orange, but I think yours was 24.
Right? Yeah. And and and we used to
kind of argue.
Like like, I'd say, 12 is baby blue.
And she says, what are you saying? It's
not. It's whatever color it is. Baby blue
is 12. I can see. It's like
16 more, but yeah. Hallelujah.
(54:55):
Alright. So but she also says, what is
white? Hello?
White? Zero? Zero? Yep.
Totally wrong.
White is one.
Zero is zero color.
See through. She said zero is too low
to be white. It has to be one.
Yeah. I give Zero a chance.
Aw. Yeah. That's cute.
(55:17):
Okay. Well,
then we are
almost done. We have now last chance? Last
chance? No? Okay. So we didn't speak because
she just flew in here, so we don't
last chance, you're done? Okay. We have something
called
fun time corner,
where
Jacques tells jokes and I laugh uncontrollably.
(55:39):
I might take her role then. And,
I do quotes. So I don't have any
quotes. I have just dumb jokes. So please
feel free to laugh. I already said two.
So let's go on.
Why do driving instructors make a good physical
therapist?
Because they can teach
(56:00):
fine motor skills.
Need to learn.
A physical therapist commented
that a patient being passionate about the exercise,
this felt like a stretch. Mhmm. So true.
Yeah.
(56:21):
Okay. What did the pinched nerve say to
the patient?
Before physical therapy, I was just a pain
in the neck.
Okay.
I asked one of my physical therapist students
(56:41):
how their classwork was coming along. They said
it was a joint effort.
That works for my class.
K. So here's here's my special joke.
I tell my PT that I try to
jog twice a week.
It's a running joke I have.
(57:03):
Although she does run. Not very funny.
You know
you know you're a good physical therapist when
you turn heads
every day
at work at least.
We do anyway.
We're good people because we turn heads every
day. Darn tootin'.
(57:23):
If you're an anatomist,
that is a polite way of saying that
you're a people watcher.
Oh, she's out of jokes. Why didn't the
anatomy professor tell her students that they dissected
the wrong body?
Ew. That's awful. Because she didn't have the
heart to tell them.
(57:44):
Awful.
We have awful jokes.
What common language is the most popular to
teach anatomy?
Latin?
Body language?
They're so jockey.
Some of them I chose though. Okay. Last
one. I'm not sure why people always say
that that I have bad posture,
(58:07):
but I have a punch.
I have a hunch. Sorry.
You have to do another one. This was
bad to end with. Okay. If you think
about it, nothing begins with the letter n
and ends with the letter g.
She's thinking about it. Hey. You have been
listening to the Doc and Jacques show on
KCLW Doc and Doc. KCLW one hundred point
(58:27):
seven FM in Brookings, Oregon.
We hope you have enjoyed the show as
much as we have.
Thank you, my twin, to my twin, doctor
Rica Mitchell. Thanks also for our sound engineers,
Tom Bozak and Michael Gorse and Linda Bozak
and Holm.
Thank you for listening
and you guys have a wonderful time also
(58:49):
the gang in Missouri.
Bye.
Popular Podcasts
CrimeLess: Hillbilly Heist
It’s 1996 in rural North Carolina, and an oddball crew makes history when they pull off America’s third largest cash heist. But it’s all downhill from there. Join host Johnny Knoxville as he unspools a wild and woolly tale about a group of regular ‘ol folks who risked it all for a chance at a better life. CrimeLess: Hillbilly Heist answers the question: what would you do with 17.3 million dollars? The answer includes diamond rings, mansions, velvet Elvis paintings, plus a run for the border, murder-for-hire-plots, and FBI busts.
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.