March 21, 2025 • 54 mins
Join Tom Butler as Cycling Over Sixty celebrates an exciting milestone: 100 episodes! Tom takes a moment to reflect on the journey so far and share some exciting plans for the future of the podcast. Then, Tom welcomes his friend, Denis Beaulieu, a seasoned physical therapist, to the show. Tom and Denis delve into a personal and insightful conversation about knee injuries and recovery. Denis shares his own experience with a past knee injury, and provides expert perspective on what to expect during the healing process. They discuss the critical role of physical therapy in regaining strength and mobility, offering valuable advice and encouragement for anyone facing similar challenges.
Link
CoGenerate - cogenerate.org
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Tom Butler (00:04):
This is the Cycling Over 60 Podcast, season 3,
episode 22,.
What Happens If I Injure myKnee?
And I'm your host, tom Butler.
I'm excited to share that thisepisode is a milestone for the
(00:26):
Cycling Over 60 podcast.
This is the 100th episode.
I feel like I should have had acheer sound clip available
there or something.
Maybe in the future I'll figureout how to incorporate things
like that.
The podcast started out as aneffort to chronicle my attempt
to use cycling as a way to getand stay fit.
To chronicle my attempt to usecycling as a way to get and stay
(00:47):
fit.
Along the way.
The podcast has allowed me toshare interviews with people who
inspire me, and myconversations with healthy
lifestyle professionals havehelped me make better decisions
about riding and food choices.
I'm very thankful to everyonewho has joined me on this
journey.
I love it that the podcast hasbeen downloaded in 85 countries.
My big wish is that I couldmeet everyone who listens, and
it's been so fun to meet thepeople I have who love cycling
(01:10):
and share my interest in stayingfit and healthy later on in
life.
I really appreciate all of youwho have reached out with
encouragement.
It has made a difference for meon numerous occasions.
I'm glad that I do get to seesome of you in a way in the
Strava Cycling Over 60 Club.
I really do love seeing thepictures that get posted along
with your rides.
I think it is likely that thepodcast will continue past the
(01:32):
end of Season 3, the currentseason, which is in September.
I don't have any shortage ofpeople that I'd like to bring on
.
I'm hoping that the podcasthosting provider that I use will
add some features so that I caninteract easier with listeners.
I would really like to havelisteners play a big role in
shaping the future of thepodcast.
When you send me a suggestionof a guest, I follow up on it.
(01:54):
Unfortunately, I'm notsuccessful in getting everyone
to come on.
I'm not sure why that is, butI'll keep working on reaching
out to anyone who you would likeme to interview.
One of the options to shareyour thoughts is the new Zoom
call.
It happens at 3 pm Pacific onThursdays.
You can find my email in theshow notes.
Please reach out for a link tothe Zoom meeting.
(02:15):
I had a great time talking withScott this week on the Zoom
call and I'm looking forward tointroducing him to all of you on
a future podcast.
There is also a Cycling Over 60Zwift Thursday club ride.
You do need to be a member ofthe Zwift club to join that ride
, but regardless of whether youare or not riding, I would like
to have you join the livediscussion happening each week.
(02:38):
Over the months that I've beendoing the podcast, I've gotten
more interested in seeingCycling Over 60 become a local
resource.
The podcast I've gotten moreinterested in seeing Cycling
Over 60 become a local resource.
I feel we are making some greatconnections here locally to
create a model of what CyclingOver 60 local groups could look
like.
We are quickly building supportfor a wide variety of resources
that can help introduce peopleto cycling and to keep people
going as they advance.
(02:59):
I'm looking forward to sharingthese components of a
comprehensive support program astime goes on.
I'm planning on wrapping upthis season with the first
Cycling Over 60 group ride.
I've been telling peoplelocally that the ride will
happen September 14th, startingin Puyallup, washington.
That date is still tentative asI make sure that it isn't
conflicting with any other localrides Right now.
(03:21):
I really like the plans thatare coming together for the ride
.
The final thing that I will sayabout the future of Cycling
Over 60 is that I'm looking tomake it a co-generate project.
I will soon be talking moreabout exactly what that means in
a future episode.
For now, I will just commentthat I believe there is a huge
need to get people fromdifferent generations working
together to solve the world'sproblems.
(03:41):
Visit cogenerateorg and seewhat they're up to.
I'll put that link in the shownotes To wrap up this discussion
about the 100th episode.
This podcast isn't a big deal,but I certainly find the
discussions I have withlisteners and guests to be
extremely rewarding.
I have done 10 weeks of upperbody workouts in a row so far.
(04:04):
That means my habit changestrategy is holding up well.
I got a piece of feedbackrecently from a personal trainer
that I should be looking toincrease my weight until I'm at
a level where I can only do sixreps.
In my mind I was saying look,just celebrate with me this
success.
But I know her heart was in theright place, so I'm going to do
(04:25):
a little more digging into theconcept of heavier weights and
lower reps.
I will say that I like what I'mseeing in the mirror from just
10 weeks and the big takeawayonce again is that at 62, I'm
certainly able to get strongerand build muscle, and that is
very good news.
(04:50):
I feel fortunate that my hips,knees and ankles are all
relatively healthy.
I get aches and pains, for sure, but I don't have ongoing pain
that interferes with riding.
Of course, there is the kneebursitis that I struggle with,
but I see that flaring up onlywhen I have failed to train
properly.
It isn't some ongoing problem,but I still worry about some
accident or some injury to myknee keeping me off the bike.
(05:12):
Last fall I went backpackingwith some friends, and one of
them, dennis Ballew, has had along career as a physical
therapist.
He commented on needing to takeinto consideration his previous
knee injuries when he'sbackpacking.
That immediately got me curiousabout his perspective on
recovering from knee injury, soI asked him to have a
conversation about the topic onthe podcast.
Here is that discussion.
(05:35):
Well, I feel really fortunatebecause I have a friend here
joining me.
I've known Dennis Ballew for along time and thank you, dennis,
for coming on.
Denis Beaulieu (05:44):
Oh, it's my pleasure to be here.
Thank you for asking.
Tom Butler (05:55):
Now I went on a hike last fall and Dennis was on the
hike also, and I was reallyhappy with my performance
because it really showed theadvancement I'd made in my
health gains since I startedcycling.
So that was about a year and afew months after I started
trying to get healthy withcycling and I'm really glad that
that translated into being ableto go on a hike.
(06:18):
It wasn't a super long hike butit was still a bit challenging
and I really enjoyed the groupof people that we had together
on the hike, including spendinga little bit of time with you,
dennis.
Denis Beaulieu (06:30):
Yes.
Tom Butler (06:31):
I noticed something on the hike and you actually
talked a bit about it, andthat's that you have to watch
how your knees are performingwhen you go on a hike, and I
thought that it was reallyinteresting to talk to you about
that, because you're a physicaltherapist and you've been in
practice a long time, and so Ijust thought your perspective
(06:53):
kind of on knees, which issomething that I think we have
to take into account as we getolder and want to stay active I
just thought it'd be reallyhelpful to have your perspective
on healthy knees or what to dowhen your knees aren't so
healthy.
And I'll start this way you area physical therapist and I'm
wondering what got youinterested in a career in
physical therapy?
Denis Beaulieu (07:14):
You know, it was really one of those weird
things.
When we were in high school, weall did those career searches
and it just so happened that wehad I was living in a boarding
school and it just so happenedthat our assistant deans were
pre-physical therapy collegestudents, and so they were the
ones that really introduced meto physical therapy.
(07:36):
At that point, none of us hadreally heard of physical therapy
.
So we were, I would have to say.
I would have to say there'sprobably about 30 students that
went on to be physicaltherapists just because of those
two guys.
And yeah, we, we had no cluewhat we were doing back then.
We just thought, you know,maybe we'll be teachers or
(07:57):
physical physical educationcoaches.
And then physical therapy cameon.
It's like, wait a minute,there's something medical here
as well as physical.
This looks interesting.
So that's what got me started.
Tom Butler (08:08):
I love it.
Now would you say that thefield has evolved since that
time and in recent years.
What would you say has changed?
Denis Beaulieu (08:20):
Yeah, I mean when we started off with
physical therapy back in the daythere was still quite a rehab
mentality hot packs, ultrasound,hot and cold treatments and
stuff and I would say we'vedrifted away from that just
because we know that you can dothat at home.
It doesn't take a lot ofinformation you might say to put
(08:43):
on a hot pack or ice pack.
So we've drifted from that.
When we got started, we starteddoing more activities that you
might consider to be morechiropractic or osteopathic in
nature.
So we were mobilizing andmanipulating the spine a bit
more and that has grown.
But the trends kind of come andgo.
(09:04):
Recently we're doing activitiessuch as dry needling.
I don't know if you've heard ofdry needling.
That's one of our neweractivities, especially in this
state where we use anacupuncture needle, but we're
using it more like a physicaltherapist or you might say
Western medicine would actuallyuse a needle.
We're using it as a probe tohelp stimulate a muscle, for
(09:27):
muscle re-education, not tryingto necessarily take over the
acupuncture's jobs, but we arefinding some uses for some new
tools.
We've done electricalstimulation for years, muscle
stimulation as well as paininhibition.
So that's just one of the newerthings that have been
interesting in helping us withour physical therapy.
Tom Butler (09:46):
It seems like the education of physical therapists
has changed a bit.
I don't know.
It seems like mostly what I seenow are people that have
doctorates in physical therapy.
I don't know how it was whenyou started, but again it seems
like the educationalrequirements or vigor or
(10:10):
whatever, has changed a lot overthe years.
Denis Beaulieu (10:19):
It has, taking physical therapy from a
bachelor's degree kind of like.
Well, the nurses would do twoyears of prerequisites, two
years in the nursing program,and then go sit for your boards
and become a registered nurse.
Same thing for therapists.
We started off as a registeredphysical therapist.
Then when I went throughschooling they were just
(10:40):
advancing to a master's degreeand then probably 10 years later
they were really pushing for adoctorate degree, largely to
help us become a little bit moreindependent in the medical
practice but to give us againmore of that specialized
knowledge.
I guess when you encompass allthat we do, part of our activity
(11:00):
is you might consider to behands-on, like a chiropractor,
massage therapist.
A lot of our, the bulk of ourinformation is rehab, exercise,
science, and so you're combininga lot of these different
elements then into what is now adoctorate degree.
So, but it's the same, it's thesame entry point.
When we went through themaster's program the knowledge
(11:24):
was generally the same as whatyou're getting from the
doctorate program.
There's three years in thephysical therapy program now,
and so there's just a strongerbase, I guess, from general
studies, getting a bachelor'sbefore you go through your
doctorate program in physicaltherapy.
Tom Butler (11:42):
My thought on that is that over the years, that
physical therapy has really beenseen as a vital, even part of
keeping people functioning well,keeping people healthy, and I
think that when you think aboutyou know a doctorate level
education, it's really sayingthat this, the knowledge is
(12:04):
broad, that a physical therapisthas to have and so you need to
put in the time to turn a lot ofthings, because it is playing a
role in a lot of aspects inmodern medical care.
Denis Beaulieu (12:20):
Correct and there's a lot of different
avenues that physical therapistscan take their practice.
They can be in hospital rehab,they can be in neuro rehab, it
can be an outpatient orthopedics.
There is a broad range ofgeneral studies and then each
(12:45):
therapist can kind of worktowards a more specific avenue,
whatever suits them.
And yeah, there's a lot more toknow.
You might say.
Tom Butler (12:54):
Activity is such a key aspect of longevity and I
think every year it seems likethere's, you know that's
emphasized even more, that youknow inactivity is like the new
smoking and different thingslike that.
That really you know if you'regoing to be healthy longer and
(13:14):
I'm a really specific example ofthat if you want to be healthy
longer, you have to be active,and I'm wondering how you see
the role of physical therapy inkeeping someone active for life.
Denis Beaulieu (13:28):
There's a bit of a struggle with that too,
because when someone comes to uswith a positive attitude about
recovery, getting back toactivity, it's so much easier to
work with that type of a personversus trying to, shall we say,
push someone along intophysical activity, and we've
identified that as a marker forsuccess.
(13:51):
I mean, if you're coming tophysical therapy from an injury
and you're motivated to get backto your sport or get back to
healthful living, even if it'shiking or, in your case,
bicycling, it is so much easierto guide that process versus
someone who has been inactive.
It's so much harder to.
I guess the saying that I useis you can't steer a parked car.
(14:15):
It's very hard to get someonemotivated if they're not already
moving, so that becomeschallenging.
So movement, physical health,keeping active, especially for
longevity's sake, is veryimportant active, or would you
see the majority of people youknow being active?
Tom Butler (14:32):
I mean, we hear statistics that you know only
30% of people are really active.
(14:52):
Would you say that that is whatyou see in your practice?
Denis Beaulieu (14:57):
Well, fortunately for us there's a
pleasant blend.
We have employed a lot ofathletic trainers and so we tie
into the schools a lot, so itseems like on a given day we see
a lot of young athletes.
We see a lot of young weekendwarriors too.
The other interesting aspect ofour practice is we do see a lot
of injured workers, so we do alot of occupational medicine, so
(15:21):
people trying to get back totheir job and their work, but
then there's a significantportion of those that are just
inactive.
I don't know why I started tohave this pain, but I started
having this pain Help me ofactive versus inactive adults
(15:49):
per se, just because if you'recoming to us, you're definitely
going to be working on a injuryor a pain that won't go away and
you have sought medicalattention and you figure that
physical therapy is going to bethe one that helps you.
So it's kind of an unusualblend and of course insurance
drives some of that, but for themost part there is a fair blend
(16:10):
of those that are alreadyactive versus those that are
inactive, Gotcha.
Tom Butler (16:16):
Now, in my case, I was like 59 years old.
I had probably decreased myactivity level for 30 years and
had gained weight for 30 years.
And you know, and at 59, I'mlike, okay, something's got to
be done here.
I had some disease processesthat I wanted to reverse.
(16:36):
So, given someone not havingbeen very active, you know, and
starting out in their 60s or 50s, is there a role for physical
therapy assessment beforestarting being active?
Denis Beaulieu (16:54):
You know, not really.
I think you find most peoplejust simply say, oh, I remember
I liked walking or running orcycling, and they'll jump into
that activity, which is good.
That self-starter mentality isreally what you're looking for
is somebody who wants to getback into activity.
So whether it's a court sportthat you can enjoy with friends
(17:17):
or going walking, just simplystarting is probably key to that
first step getting into youractivity.
So physical therapy doesn'tnecessarily start that process,
but we're definitely there alongthe way.
If injury would happen, say ifsomebody started a walking
program and realized that theywere using poor shoes and ended
(17:39):
up with foot ankle problems orhip problems, that's when you'll
see physical therapy becominginvolved.
We're really down the journeyaway, not so much as an entry,
return to sport or return toactivity type of industry.
Tom Butler (17:54):
The reason that I asked that is because I ended up
developing bursitis.
I was on a ride and it kickedin.
It was the first longer ride Ihad done.
It was actually on my 60thbirthday and I really yeah, so
cycling over 60 kind of that'spart of what created this, and
(18:16):
it was the longest ride I haddone in a long time, and at
about the 50 mile mark I starteddeveloping some knee pain.
It got pretty bad by the time Ihit the 60 miles and I went in
and you know it felt likeeverything pointed toward
bursitis and so so what happenedwith that physical therapy
(18:39):
appointment?
And you know what happenspretty much any physical
therapist that would look at me,you know they'll say, like
touch your toes or somethinglike that, and then they become
pretty much horrified that Ihave so little flexibility, you
know yep and so you know I getthese exercises for flexibility.
(19:05):
The thing is, you know, was Iget these exercises for
flexibility?
The thing is, you know, wasthat something?
It seems like that's somethingthat I could have gone in to a
physical therapist and said, hey, I'm getting ready to be more
active than I've been in thelast you know, easily 25 years,
(19:26):
maybe 30.
Could we talk about some of thethings that might interfere
with me being able to be active,and would they have maybe
checked for flexibility at thattime and said, hey, you know
this is going to be an issue foryou if you're not flexible.
What do you think about thatkind of free activity assessment
later on in life?
Denis Beaulieu (19:44):
Well, tom, that would be a refreshing visit.
I would so enjoy that visitwith you because you know, if
somebody is starting back to anactivity, there is some key
points you can look atFlexibility strengthening.
How much load and how muchprogression do you do?
So there's a couple of ways wecould help.
(20:07):
We could look at thatflexibility, strength and kind
of help you design a morecomprehensive program, I suppose
, than to just go back and seewhat 60 miles is going to feel
like.
But you're also kind of we'rein the middle and I'll give a
shout out to the athletictrainers of the world.
(20:27):
They're underutilized, to behonest.
They're really your performanceexperts when you are going
through a recovery like frombursitis, once you've discovered
that you can, you can't just do60 miles in a in the drop of a
hat.
There is some training andpre-training that you should be
doing, or even cross-trainingyou should be doing as you get
(20:49):
back to an activity when you'rerestarting later on in life.
But athletic trainers, they'reunderutilized, mostly because
they're and this gets into somestrategies mostly because that's
cash out of your back pocket,and this gets into some
strategies mostly because that'scash out of your back pocket.
So you have to actually go seekout a trainer, seek out
somebody who knows your sport orbe familiar with your activity,
(21:11):
and yeah, they probably don'tget utilized as much.
You go to the gym and you say,oh yeah, I get that one athletic
trainer appointment to learnthe equipment, but you can
actually secure their servicesto help guide you through this
return to exercise how much load, what should my nutrition be,
(21:34):
what should I be doing on offdays and how many days should I
train?
So they're really in a keyposition to help.
I would love to do thatappointment and say, oh yeah,
you've got some flexibilityconcerns.
You have some mobility concerns.
You may want to look at theseissues before you jump right
into this sport, but I wouldhave to say let's give a shout
(21:58):
out to the athletic trainers ofthe world and give them a shot.
I love it.
They are the performance guys.
We sometimes miss that spot.
I mean, we are good at it, butwe're good at bringing you from
the ACL injury back to hey.
I think you're ready to go hitthe field and get back to
football or get back tobasketball.
(22:19):
In that mix, though, we reallylike to use our athletic
trainers.
So there's a shout out forthose guys.
Tom Butler (22:27):
Great, and so do you have athletic trainers on staff
.
Is that right?
Denis Beaulieu (22:40):
We do and we use the athletic trainers as much
as we can in clinic, but a lotof our athletic training staff
are also then working at thehigh schools and helping their
athletic programs, which, withthe rise of concussion awareness
, that has been a big job for usas far as helping kids that
have gone through concussioninjuries in their recovery
process.
So we've become part of thatprocess then, with the athletic
trainers being a very key pointof that.
Tom Butler (23:03):
Interesting so yeah.
Now, what do you think aboutcycling as an activity to stay
fit later on in life?
Do you have a professionalopinion about that?
Denis Beaulieu (23:14):
It's a great activity If you think of the you
know load on the joints if youwere to start, say running
versus cycling.
There's less impact withcycling, certainly more ground
to cover, boy, you can get outand see some scenery More than
just the three times around theblock walking.
So there's definitely somegreat aspects to cycling, but
(23:37):
there's also things that wecould talk about too, like the
bursitis issue.
How do I prevent things likethat from happening?
When you go back to a cyclingactivity that is very, shall we
say, linear, it's a forwardmotion.
There's not a lot of variety tocycling.
Your legs and your hips, kindof, are doing that same forward,
(23:58):
forward motion.
So that's that's probably wherewe start to see issues like
your bursitis.
You may need to becross-training a little bit, so
that's that's part of theconcern I guess I would say
between, uh, with any one sport,that you make sure that you're
actually training andcross-training and developing
(24:18):
the whole body, as opposed tomaybe a specific muscle group.
Tom Butler (24:23):
So there's also you know what I've heard a few times
is, the position of cycling issomething that you know, along
with the, the position thatwe're sitting in front of a
computer, kind of bent over infront of a computer, kind of
that combination.
Can you know, cycling does notlike offset or confront or
(24:47):
whatever, that kind of positionproblem.
Denis Beaulieu (24:51):
Right, because you're utilizing the same
muscles that you're going to beconcerned with.
Let's say we're talking about a40 year old who has been
sitting in his office chair foryears.
Their stiffness is going to bealong the same lines of muscles
that you're going to be using asa cyclist.
So the use is really good,because in order to stretch a
muscle, you know that you haveto use those muscles.
(25:13):
So if we want to talk abouthamstrings and hip flexors for
what I call a sitting athleteSomebody who's going to be
behind the desk working on thecomputer, sitting in a chair for
long periods of time, versussomebody who's going to be
starting cycling there are someof the same muscles that you can
(25:33):
work on, but you still want towork on cross-training.
You still want to work on someof the more lateral muscles
instead of just the forward hipflexors and hamstrings.
They share a similar concernand they can help, like you can
use your cycling to help withyour long-term sitting, but you
(25:54):
still want to cross-train.
You still want to utilize someother muscles to support that.
Tom Butler (25:59):
Now on a bicycle.
You know, and it's incrediblewhen you start crunching the
numbers, but you know, like theSeattle-Portland ride, which is
like a 206 mile over two days,you know when you're pedaling at
90, 95 reps per minute and youknow you're doing a lot of
(26:20):
repetitive motion over you knowthe two days of the stp and so
it seems like if there's, youknow, a little bit of alignment
by the time you repeat thatmotion over and over again, then
that misalignment is really aproblem and I found a good bike
fitting to be really importantto me.
But I'm wondering about yourperspective on that.
(26:41):
What do you think about whenyou think of, like the
repetitive motion and getting abike fit to you know, to the
individual?
Denis Beaulieu (26:50):
Yeah, there was.
I know I recall there was somecoursework that came through for
physical therapists on how tohelp with this exact problem as
we look at various sports in ourarea.
You know that was one of thethings that came up.
It's like we should be helpingthis bicycling community with
bike fit, and maybe you couldhelp me know more about that too
(27:13):
, because I would assume thatsome of the bicycle shops that
are selling you their equipmentwould also have some expertise
in that as well.
Do you find that to be true?
Is there a bike?
Tom Butler (27:24):
fit.
I think there's a coupledifferent things that go on.
I think that bike shopsunderstand if people are
comfortable when they're riding,they're going to be happier
with that purchase, be happierwith that purchase.
And so I think there's a layerof bike fitting that goes on,
that like gets you to the pointwhere you feel good on the bike.
(27:45):
But then there's a totallydifferent layer of bike fitting
and I think many of the peopleat that in that place are
physical therapists, wherethey're, you know it's really a
science and they'll use laserguides and everything.
And there's, you know, like adifferent level, and a lot of
(28:07):
times there's a price differencebetween those levels.
But you know that to me thattop level is so valuable that
it's, you know, if you'replanning to spend much time at
all on a bicycle, then it's goodto you know to be at that level
.
Denis Beaulieu (28:27):
Correct yeah.
And I think that's where I wasjust going to say.
I think that's where some ofthe added emphasis could lie.
For physical therapists ingeneral, it's a specialized
market.
For many years I tracked downthe specialized market for golf.
There's a lot of things that wecan do for golf, fitness and
(28:47):
helping to improve the one toolthat most people can change,
which is their body.
You can be fitted for clubs,you can be fitted for grips, but
one of the hardest things toactually change is the physical
body.
So physical therapists havedone quite a bit of studies
there.
It would behoove us, I guess,to spend a little bit more time
(29:10):
for the cycling community toactually take on the training
for the bike fit.
I know that's available to us,but I would say only a few
samples of people that I knowhave actually gone through the
training.
So it would probably suit us tohelp your community of cycling
well into the 60s to be able todo that performance assessment
(29:33):
for you.
Tom Butler (29:34):
Yeah, I think it's an interesting observation, you
know, because I do think there'speople that you know like spend
their time as professionalcyclists and then get done with
that and go, you know, dophysical therapy, training, and
then they become a reallynatural kind of from a marketing
perspective.
They have that advantage to,you know, pull that in, as
(29:55):
they're talking about what theydo, about what they do.
But you know, I would like tosee cycling become so massive in
the United States that you knowthere's more and more need.
And so you know every physicaltherapy clinic would want to be
able to offer that, so we'll seehow that goes.
Denis Beaulieu (30:16):
Yeah, I mean again making our community more
aware of the cycling needs, ofhow to better stay in the game,
if you will, of cycling on yourcommunity.
If we were to spend a littlebit more time making sure we
knew a few specializedassessment tools that would help
(30:43):
your you stay on the bike foryears to come, if you will yeah,
nice.
Tom Butler (30:48):
Now it seems, as I get older, like I have more
aches and pains, you know it'slike just the.
It's just normal to step out ofbed with some some kind of ache
, and so I am wondering you knowwhat would differentiate like
normal muscle soreness after aride versus a potential injury?
(31:12):
I don't know if that questionmakes sense, but how do you, how
do you make that decision that,okay, this isn't normal?
This is something that I needto go seek some attention for.
Denis Beaulieu (31:24):
Yeah, I think most people come to that
naturally.
Basically, if a pain doesn't goaway like it did last time, or
if it doesn't go away in areasonable amount of time with
reasonable efforts ofconservative care ice, heat,
medication over the counter andthose types of things then
(31:45):
you're seeking help.
It's like this is going on waytoo long and that's where we see
a lot of people come intotherapy for an assessment.
It's like I have this pain.
I started getting back into mysport and now I feel like this
is stopping me from my sport.
Help me.
So, yeah, it's, it's those.
It's kind of intuitive, I guess.
(32:06):
If a pain persists and doesn'tget better with your
conservative methods, we'rethere for you.
Yeah, we'll see you in therapy.
Yeah.
Tom Butler (32:15):
Okay.
Denis Beaulieu (32:16):
But there's no magic.
There's no magic to it.
You know.
You know you're going to besore after cycling, I know I'm
going to be sore after playingracquetball or pickleball.
And so you monitor it, you playthrough it, you strengthen
through it and, yeah, if itdoesn't get better, you consult
your doctor, they send you tophysical therapy and we hook up
(32:43):
we hook up.
Tom Butler (32:43):
So you know, I mentioned earlier one of the
things that I always consider isI am very thankful that my
knees are in good shape.
I do have to be careful.
I can get bursitis, but youknow I don't have knee problems.
But that's not really the casefor you, right Like you have
some knee problems, and so Iwonder if you could talk a bit
about that.
Denis Beaulieu (33:03):
So, yeah, I wish I had a great story for my
injury, but it was a longshortcut.
I was trying to cut across afield and it required going down
a steep slope and I twisted andturned and basically tore my
ACL and meniscus as I wasfalling.
That was several years ago andI rehabbed the knee.
(33:25):
I felt I came back to 100%really well and then, just over
time sports applications I wasable to injure it again.
So's, it's been an interestingprocess then for me to stay
active in sports, because I do,like everybody else, uh, working
(33:46):
out, exercising is not nearlyas fun as being out playing,
cycling, uh, playing a sport.
So I, uh I train now or do myown exercise routine so I can
stay out on the court, and thatprocess comes and goes.
There's, you know, again, themonitoring of injury and
swelling and how the arthritisis advancing.
(34:10):
So I have to be a little morevigilant with what I do with my
knee again to keep me happy,going backpacking like we did,
and or staying on the court tobe active and stay healthy.
So it's an interesting processthen, when you're dealing with
that persisting arthritis frompast injury.
(34:31):
That's probably an area wherephysical therapy can really help
the injured athlete, theinjured adult who wants to stay
in their sport.
How do you strategize throughsome of that?
What do I do?
Now?
It's really kind of the bigquestion we hear.
I think that's where you cansee physical therapy really help
you with the strategy.
A lot of people are afraid toexercise because they have
(34:52):
arthritis.
They have this diagnosis now ofarthritis.
Well, one of the best things isgetting education.
What does that really mean foryour knee or for your hip or for
your shoulder?
It doesn't mean you stop allactivity and unfortunately, a
lot of people do believe theystop activity.
So we're the proponents thatwould help you get back to the
(35:13):
activity, learn what arthritisreally does for your body and
how you can support that so youcan stay active.
Tom Butler (35:21):
I think it's more fascinating that you did this
injury just in some like mundaneactive.
You know average activity, Imean I think it says something
about how we can get injured.
It's not you know, if you'renot being active, you know you
(35:43):
can just as easily maybe notjust as easily, but you can
injure something in a mundaneway.
Denis Beaulieu (35:51):
Oh for sure, I mean home injuries.
Home accidents, that is really.
We see a lot of those types ofinjuries.
It's not all car accidents insports, some of it's just the
silly stuff we do.
I went out and stepped out ontomy back porch and slipped on
the ice and now I have an injury, so it can be just as
(36:12):
pedestrian as that.
Not every story comes with thegreat sports injury where I was
going up for that winning shotand got hurt.
So most of us do get hurt in somany boring ways.
So now, that's that's where wefind everybody.
That's where we find, uh, youknow, the, the avid cyclists
(36:33):
such as yourself.
Uh, might, it might be adifferent injury that you
incurred.
Tom Butler (36:38):
Yeah, when you look back at it, do you think there's
some things that you could havebeen or should have been doing
that would have prevented thatstress from leading to damage?
Or is it just that things?
Denis Beaulieu (36:57):
like that can just happen.
No, for me it was justsomething uh, it's something
that could happen.
Um, maybe I should not havetaken the shortcut, but I did.
I mean, I'm young, healthy guy,I can go through this field.
Injuries and accidents, theyhappen, uh, to all of us.
Really.
There's no way to prevent that,maybe being a little bit
(37:18):
smarter.
But I think we all come to thatpoint where it's like, well, I
thought I could actually do thatactivity and I guess now I
can't.
It can be as simple as walkingout on your front porch or I was
out line dancing with myfriends and twisting an ankle.
Well, there's no way to preventthat.
(37:38):
So we're, all you know, victimsof gravity, I suppose.
Tom Butler (37:43):
That's a very good point.
Victims of gravity, you know,until we have those full body
airbags that just inflate, youknow, whenever you start going
down or something I don't know.
Whenever you start going downor something I don't know, when
you had your injury, I'mwondering what thoughts went
through your mind.
Did you feel like you knew whatto do?
(38:06):
Did you feel like you learned alot about rehabbing something
in that process of dealing withit yourself?
Denis Beaulieu (38:15):
What's your perspective there?
Well, what's really interestingis that I was actually
diagnosing my injury as I fell.
My foot went into a hole and itstarted twisting as I fell
forward.
I'm like, oh no, I just tore myacl and meniscus, you know it
was.
It was kind of surreal, Isuppose.
On you know it's like is thishappening?
(38:35):
Happening?
Yes, it happened.
And then, of course, I go to mybuddy and I'm like, all right,
test my knee.
I know I tore my ACL and so mybuddies would test my knee and
I'm like, oh, I guess it's notso bad Initially, I just tore it
.
And then, five weeks later inmy rehabilitation, I forgot that
(38:56):
my knee was injured.
We had done so well atrehabbing my knee and five weeks
later I jumped off of a it wasa little partition wall at
Multnomah Falls.
I jumped off of the wall backonto the trail and completely
finished rupturing my ACL.
So, insult to injury.
(39:17):
And yeah, that was the amazingprocess.
I'm like, oh man, I did it.
I forgot my own injury and Iinjured it again.
So, yeah, even as smart as weare in the rehab industry, we're
all stupid when it comes toinjuries.
I suppose, uh, but you know,self-diagnosed.
My family was like, oh, oh, no,we need to take you to the
(39:37):
hospital.
And I was like, well, I tore mymeniscus and my acl.
I finished rupturing that.
So let's just put me down hereat the bottom of the hill.
You guys finish your hike,enjoy multnomah falls.
I'll see my doctor on monday.
So I guess that's the addedexpertise that I had.
I got to self-diagnose but, um,you know, I still had to go
(40:00):
through the rehab.
Once I finally got the surgeryto, decided to have a surgery to
re uh, to repair the ACL, Istill had to go through the
rehab.
I still needed guys to help me.
So I couldn't do it.
I couldn't move my leg.
So I had a really good crew andkind of knew what to do.
But, to be honest, even whenyou're a client or a patient,
(40:23):
you still need that help.
Even if you know all theinformation, you can't do it all
by yourself.
So that is where physicaltherapy does shine.
That's where we come in.
Tom Butler (40:32):
You talked about surgery.
It doesn't sound like in thatcase there's a decision to be
made when you totally tear it.
There's not really a decisionmade about whether or not to do
surgery.
Is that correct?
Denis Beaulieu (40:46):
Well, not really actually.
In fact, the doctors in my townwho had been sending me their
ACL reconstruction clients hadbeen sending me their ACL
reconstruction clients.
All three doctors that I wentto were telling me to not do the
surgery because we're decidingthat we're just going to let
people get strong and we'll seeyou later down the road.
(41:07):
Anyway, for me, I was still inmy 20s, still felt I had a lot
of sport and game to play anddidn't want to stop there, and I
knew what a non-surgicalruptured ACL looked like 30
years, 40 years later, because Ihad been treating those clients
(41:28):
too.
So I actually had to go outsideof my health network and find a
doctor that would treat my kneeand do the surgery.
Now it was the most bizarremoment of the whole thing for me
as a rehab specialist that mydoctors did not want to do rehab
or didn't want to do thesurgery on my knee.
So I guess I really wanted thesurgery because I knew that I
(41:51):
wanted the performance out of myknee later on in life and I
would say I made the rightdecision for me.
There may be something differentin the decision process for
somebody who well, let's talkabout bicyclists Do you
necessarily need an ACL forcycling?
And I would say not really.
(42:12):
If you're youth over 50 and youdon't want to go through the
surgery of getting an ACLreconstruction, you could
probably do quite well ifcycling was your primary sport,
because then you can work onstability and control of the leg
in the absence of an ACL.
So there are some options forpeople and you still have to
(42:32):
make that decision with yourdoctors, sometimes with second
and third opinions with thedoctors, but there there is
still that opportunity to gothrough and repair something
that has been broken a brokenbone, a broken ligament, muscle
that gets ruptured.
Each one of those, in each oneof those cases, has their own
(42:55):
unique features and and you haveto then take that case by case,
person by person, and reallyconsider whether that surgery is
important or not for you.
So that's a big decision.
That's usually one that you'rereally involving your doctor.
Of course, everybody asks theirfriends did you get the surgery
(43:16):
?
Yeah, I got the surgery, or no,I wouldn't do that, I would
never do that.
So you have to weigh all thisinformation.
Now, as somebody who's seekingmedical attention, what do I do?
So?
But I think the medical fieldis good at helping you process
through that, and the rumor millis good too.
You can ask your friends, youcan ask your buddy hey, you went
(43:39):
through that surgery.
Should I do it?
And that's not the best advice,but it is still the advice we
seek, isn't it so?
Well, it's, it's, it's probablynot.
Tom Butler (43:50):
It's probably not bad advice.
Taking in an aggregate of a lotof different advices, it's like
, okay, what did you go through,how did you experience that?
And you add that to maybe someinternet research and to some
medical advice.
That's taking into account yourpersonal situation, so you know
(44:10):
as a you know, again as a piece, but maybe not the only source.
Denis Beaulieu (44:17):
Yes, correct, correct, yeah, and physical
therapy actually becomes part ofthat process.
Can we conservatively treatthis injury and not do heroic
surgery?
Can we let the body heal if wesupport it with proper activity?
So we do see a fair number ofcases in that category where,
(44:38):
okay, you might have strained ortorn part of the rotator cuff.
Do you really need surgery?
Well, let's explore that so webecome a really interesting part
of that process for you whenyou're considering your injury
and considering yourrehabilitation.
Will I be complete or will I beto the position I need to be to
(44:59):
continue doing what I want todo in life?
So it's a really nice avenuefor what we do in physical
therapy.
Tom Butler (45:06):
So you are again staying active.
You have knee pain and yetyou're throwing a backpack on
and going hiking.
Can you talk about that processin your mind?
Because, again, you know morekind of what's potentially going
(45:27):
on than maybe the averageperson.
And so what's that thoughtprocess in your mind about
staying active and about painand being active and the
different layers of decisionsthat go on for you to be active?
Denis Beaulieu (45:43):
Yeah, fortunately I can speak well to
it because I did what everybodyelse did in life.
I had my ACL injury early inlife, went through the rehab.
I had an interestingperspective one day when I went
to do an activity and realizedthat maybe I wasn't at 100%
anymore.
I went to climb a telephonepole at one of those adventure
(46:08):
parks where you are climbing anddoing the high ropes adventures
, walking across the cablebridges and things like that.
So one of the last events wasclimbing a telephone pole and
standing on top of the telephonepole and I realized I couldn't
take that steep step with myright knee and so that was a
(46:29):
little bit of a shock todiscover that I wasn't as
bulletproof and maybe not at100% like I thought I was, that
I wasn't as bulletproof andmaybe not at 100% like I thought
I was.
So that processing then kind oflearning through life, that my
sedentary moments kind of tookme on my own little journey with
my knee and my knee did not dowell if I was sedentary.
(46:50):
As soon as I got back intoactivity, went through
strengthening, conditioning,participated in my sports, I was
able to actually feel better.
My knee would respond better today-to-day activities as well
as the sport activities.
So it's been a reallyinteresting learning process for
me to enjoy exercise and toenjoy training and getting my
(47:14):
knee back into a satisfactoryposition, a satisfactory
condition to help me stay activeand stay healthy.
So it's been quite a journey.
We'll often tell our clientsthings like you know, for your
arthritis, motion is lotion.
So we have all these littlesayings.
But it really is about how thebody responds.
(47:36):
If you maintain an active,healthy lifestyle, your body
will have the tendency to healbetter.
It'll have the tendency torecover, shall we say, faster,
or recover at least to a betterposition if you're active.
If you're inactive, there's somany more problems that we have
to deal with just in rehabbing,let's say, your knee.
(47:59):
There's more that we have toconsider Now.
We have to look at your ankleand your hip and your back and
everything else that goes alongwith that.
So I think the real drivingpoint of this discussion is
activity is so important forlongevity, muscle mass is
important.
Longevity is so important forlongevity, muscle mass is
(48:19):
important.
So you need to be engaged inactivities that will improve
your muscle mass for longevity.
One of the research pieces thatI came across recently was one
of the best predictors oflongevity was actually muscle
mass.
That was kind of a shock,really, because you would think
that there would be other healthbenefits that would go along
(48:40):
with that, like maybe heart rateor blood pressure, blood sugars
and all those.
But one of the betterpredictors of longevity is
muscle mass.
So that takes us right back toactivity.
How do we stay active, how dowe engage in this so that we can
continue our sport, ourrecreation, the real stuff that
brings us joy in our life?
Should we say so?
(49:09):
It's been an interesting journeyfor my own personal need that I
can actually then share with myclients, because you know
they're struggling, they'rethinking I'm never going to get
back to work again, or I'm nevergoing to get back to hiking
again.
Work again, or I'm never goingto get back to hiking again.
It's like, well, let's try itand see, because you don't know
what this process will be.
Let me share my experience andlet's help take you through your
experience to see what you canget back, and I think that's
really been.
(49:30):
Some of the joy in physicaltherapy is seeing people recover
from what they might havethought to be a sport ending or
a event ending injury.
There was one client inparticular who was halfway
through training for a marathonand they injured their body and
(49:50):
thought, oh, I'm never going toget to that marathon that I'd
signed up for.
And we were actually able toget them through that process
quicker than they thought, backinto the training circuit and
able to go to that marathon.
So it was really kind of a neatprocess seeing someone go
(50:10):
through that higher competitivelevel of training, have a
breakdown, get them back totheir training level before the
event.
So that was probably one of themost rewarding events ever and
you know how marathons arereally tough on the body, so
that was very satisfying to seethis client go through that
process.
(50:31):
So I think there's some of thatfor everybody.
Tom Butler (50:34):
I love that story and I love what it says about
the power of the body to heal,right, right.
If you look at structuring aprogram that works with the
body's ability to heal, there'samazing things that you can do,
and I think the really importantnews for someone like me is
(50:56):
keep going, find a way Even ifthere's an injury.
You know it might slow you downa bit, but figure out how to
keep moving, keep being activeand connect with someone like
yourself who has professionalexperience with that, and then
comply with what you say.
Denis Beaulieu (51:20):
Well, right, that's the other corner of that
little piece of the puzzle.
Compliance is tough.
I don't want to do thisexercise.
I wasn't doing it before and Iwas fine Helping people see that
some level of activity whetheryou were inactive before or
highly motivated before, thereis a dosage of activity that
helps you rehab and helps youget better, helps you improve,
(51:42):
helps you recover from an injury, and that's where it really
does take a professional.
It takes somebody who knows orhas maybe seen a few of these
before, to help you through thatprocess of recovering from your
bursitis or aches and painsthat just don't seem to go away
and they're hindering my sport.
We've seen it before.
(52:03):
We can help you through thisprocess.
So that is the pitch forphysical therapy.
When it comes to cycling over60, I guess is let us help you
where we can and maybe seebeyond the hedge that's in front
of you and help you breakthrough some of those ideas and
concepts that may be preventingyou from wanting to continue
(52:24):
cycling or whatever sport youchoose.
Tom Butler (52:26):
Yeah, I like that Well.
Dennis, thank you so much fortaking the time.
I really appreciate youbringing your perspective, both
as a professional and then assomeone who has his own journey
as far as being active, and Ijust think that it's valuable to
get the combination of thatperspective.
(52:47):
And thanks again for coming on.
Denis Beaulieu (52:49):
Oh, it's been my pleasure, and you've actually
kind of sparked some interest inmy mind as well about how do we
help these cyclists in theirpursuits, so I appreciate that
as well.
Tom Butler (53:00):
Nice, all right, talk to you later.
Denis Beaulieu (53:03):
All right, goodbye.
Tom Butler (53:04):
Bye now.
Here's the biggest takeawayfrom that discussion for me.
I think I can worry less abouta knee injury taking me off the
bike for an extended period oftime.
Sounds like many people recoverwell enough to keep going in a
(53:25):
reasonable time.
But once again I heard afamiliar message from Dennis.
I need to think aboutcross-training.
I'm really not attracted to theconcept of cross-training Plus.
I'm doing some cross-trainingalready in the upper body
workouts I do.
I do think maybe I need tospecifically seek out some
activities that can generatemore lateral movement than what
I get from the pedaling motion.
(53:45):
So off I go again on anotherjourney.
This one discoveredcross-training.
That isn't boring.
I would love to hear if youfound a form of cross-training
that you enjoy.
You can find my email in theshow notes or, for a quick way
to message me, click the send mea text message link at the top
of the episode description.
I'm getting excited that warmerdays are coming to my part of
the world.
I will welcome a day to get outin short sleeves and shorts.
(54:08):
I hope, wherever you are, youwill have some great weather to
ride in as soon as possible.
And remember, age is just agear change.
This is the Cycling Over 60 Podcast, season 3,
episode 22,.
What Happens If I Injure myKnee?
And I'm your host, tom Butler.
I'm excited to share that thisepisode is a milestone for the
(00:26):
Cycling Over 60 podcast.
This is the 100th episode.
I feel like I should have had acheer sound clip available
there or something.
Maybe in the future I'll figureout how to incorporate things
like that.
The podcast started out as aneffort to chronicle my attempt
to use cycling as a way to getand stay fit.
To chronicle my attempt to usecycling as a way to get and stay
(00:47):
fit.
Along the way.
The podcast has allowed me toshare interviews with people who
inspire me, and myconversations with healthy
lifestyle professionals havehelped me make better decisions
about riding and food choices.
I'm very thankful to everyonewho has joined me on this
journey.
I love it that the podcast hasbeen downloaded in 85 countries.
My big wish is that I couldmeet everyone who listens, and
it's been so fun to meet thepeople I have who love cycling
(01:10):
and share my interest in stayingfit and healthy later on in
life.
I really appreciate all of youwho have reached out with
encouragement.
It has made a difference for meon numerous occasions.
I'm glad that I do get to seesome of you in a way in the
Strava Cycling Over 60 Club.
I really do love seeing thepictures that get posted along
with your rides.
I think it is likely that thepodcast will continue past the
(01:32):
end of Season 3, the currentseason, which is in September.
I don't have any shortage ofpeople that I'd like to bring on
.
I'm hoping that the podcasthosting provider that I use will
add some features so that I caninteract easier with listeners.
I would really like to havelisteners play a big role in
shaping the future of thepodcast.
When you send me a suggestionof a guest, I follow up on it.
(01:54):
Unfortunately, I'm notsuccessful in getting everyone
to come on.
I'm not sure why that is, butI'll keep working on reaching
out to anyone who you would likeme to interview.
One of the options to shareyour thoughts is the new Zoom
call.
It happens at 3 pm Pacific onThursdays.
You can find my email in theshow notes.
Please reach out for a link tothe Zoom meeting.
(02:15):
I had a great time talking withScott this week on the Zoom
call and I'm looking forward tointroducing him to all of you on
a future podcast.
There is also a Cycling Over 60Zwift Thursday club ride.
You do need to be a member ofthe Zwift club to join that ride
, but regardless of whether youare or not riding, I would like
to have you join the livediscussion happening each week.
(02:38):
Over the months that I've beendoing the podcast, I've gotten
more interested in seeingCycling Over 60 become a local
resource.
The podcast I've gotten moreinterested in seeing Cycling
Over 60 become a local resource.
I feel we are making some greatconnections here locally to
create a model of what CyclingOver 60 local groups could look
like.
We are quickly building supportfor a wide variety of resources
that can help introduce peopleto cycling and to keep people
going as they advance.
(02:59):
I'm looking forward to sharingthese components of a
comprehensive support program astime goes on.
I'm planning on wrapping upthis season with the first
Cycling Over 60 group ride.
I've been telling peoplelocally that the ride will
happen September 14th, startingin Puyallup, washington.
That date is still tentative asI make sure that it isn't
conflicting with any other localrides Right now.
(03:21):
I really like the plans thatare coming together for the ride
.
The final thing that I will sayabout the future of Cycling
Over 60 is that I'm looking tomake it a co-generate project.
I will soon be talking moreabout exactly what that means in
a future episode.
For now, I will just commentthat I believe there is a huge
need to get people fromdifferent generations working
together to solve the world'sproblems.
(03:41):
Visit cogenerateorg and seewhat they're up to.
I'll put that link in the shownotes To wrap up this discussion
about the 100th episode.
This podcast isn't a big deal,but I certainly find the
discussions I have withlisteners and guests to be
extremely rewarding.
I have done 10 weeks of upperbody workouts in a row so far.
(04:04):
That means my habit changestrategy is holding up well.
I got a piece of feedbackrecently from a personal trainer
that I should be looking toincrease my weight until I'm at
a level where I can only do sixreps.
In my mind I was saying look,just celebrate with me this
success.
But I know her heart was in theright place, so I'm going to do
(04:25):
a little more digging into theconcept of heavier weights and
lower reps.
I will say that I like what I'mseeing in the mirror from just
10 weeks and the big takeawayonce again is that at 62, I'm
certainly able to get strongerand build muscle, and that is
very good news.
(04:50):
I feel fortunate that my hips,knees and ankles are all
relatively healthy.
I get aches and pains, for sure, but I don't have ongoing pain
that interferes with riding.
Of course, there is the kneebursitis that I struggle with,
but I see that flaring up onlywhen I have failed to train
properly.
It isn't some ongoing problem,but I still worry about some
accident or some injury to myknee keeping me off the bike.
(05:12):
Last fall I went backpackingwith some friends, and one of
them, dennis Ballew, has had along career as a physical
therapist.
He commented on needing to takeinto consideration his previous
knee injuries when he'sbackpacking.
That immediately got me curiousabout his perspective on
recovering from knee injury, soI asked him to have a
conversation about the topic onthe podcast.
Here is that discussion.
(05:35):
Well, I feel really fortunatebecause I have a friend here
joining me.
I've known Dennis Ballew for along time and thank you, dennis,
for coming on.
Denis Beaulieu (05:44):
Oh, it's my pleasure to be here.
Thank you for asking.
Tom Butler (05:55):
Now I went on a hike last fall and Dennis was on the
hike also, and I was reallyhappy with my performance
because it really showed theadvancement I'd made in my
health gains since I startedcycling.
So that was about a year and afew months after I started
trying to get healthy withcycling and I'm really glad that
that translated into being ableto go on a hike.
(06:18):
It wasn't a super long hike butit was still a bit challenging
and I really enjoyed the groupof people that we had together
on the hike, including spendinga little bit of time with you,
dennis.
Denis Beaulieu (06:30):
Yes.
Tom Butler (06:31):
I noticed something on the hike and you actually
talked a bit about it, andthat's that you have to watch
how your knees are performingwhen you go on a hike, and I
thought that it was reallyinteresting to talk to you about
that, because you're a physicaltherapist and you've been in
practice a long time, and so Ijust thought your perspective
(06:53):
kind of on knees, which issomething that I think we have
to take into account as we getolder and want to stay active I
just thought it'd be reallyhelpful to have your perspective
on healthy knees or what to dowhen your knees aren't so
healthy.
And I'll start this way you area physical therapist and I'm
wondering what got youinterested in a career in
physical therapy?
Denis Beaulieu (07:14):
You know, it was really one of those weird
things.
When we were in high school, weall did those career searches
and it just so happened that wehad I was living in a boarding
school and it just so happenedthat our assistant deans were
pre-physical therapy collegestudents, and so they were the
ones that really introduced meto physical therapy.
(07:36):
At that point, none of us hadreally heard of physical therapy
.
So we were, I would have to say.
I would have to say there'sprobably about 30 students that
went on to be physicaltherapists just because of those
two guys.
And yeah, we, we had no cluewhat we were doing back then.
We just thought, you know,maybe we'll be teachers or
(07:57):
physical physical educationcoaches.
And then physical therapy cameon.
It's like, wait a minute,there's something medical here
as well as physical.
This looks interesting.
So that's what got me started.
Tom Butler (08:08):
I love it.
Now would you say that thefield has evolved since that
time and in recent years.
What would you say has changed?
Denis Beaulieu (08:20):
Yeah, I mean when we started off with
physical therapy back in the daythere was still quite a rehab
mentality hot packs, ultrasound,hot and cold treatments and
stuff and I would say we'vedrifted away from that just
because we know that you can dothat at home.
It doesn't take a lot ofinformation you might say to put
(08:43):
on a hot pack or ice pack.
So we've drifted from that.
When we got started, we starteddoing more activities that you
might consider to be morechiropractic or osteopathic in
nature.
So we were mobilizing andmanipulating the spine a bit
more and that has grown.
But the trends kind of come andgo.
(09:04):
Recently we're doing activitiessuch as dry needling.
I don't know if you've heard ofdry needling.
That's one of our neweractivities, especially in this
state where we use anacupuncture needle, but we're
using it more like a physicaltherapist or you might say
Western medicine would actuallyuse a needle.
We're using it as a probe tohelp stimulate a muscle, for
(09:27):
muscle re-education, not tryingto necessarily take over the
acupuncture's jobs, but we arefinding some uses for some new
tools.
We've done electricalstimulation for years, muscle
stimulation as well as paininhibition.
So that's just one of the newerthings that have been
interesting in helping us withour physical therapy.
Tom Butler (09:46):
It seems like the education of physical therapists
has changed a bit.
I don't know.
It seems like mostly what I seenow are people that have
doctorates in physical therapy.
I don't know how it was whenyou started, but again it seems
like the educationalrequirements or vigor or
(10:10):
whatever, has changed a lot overthe years.
Denis Beaulieu (10:19):
It has, taking physical therapy from a
bachelor's degree kind of like.
Well, the nurses would do twoyears of prerequisites, two
years in the nursing program,and then go sit for your boards
and become a registered nurse.
Same thing for therapists.
We started off as a registeredphysical therapist.
Then when I went throughschooling they were just
(10:40):
advancing to a master's degreeand then probably 10 years later
they were really pushing for adoctorate degree, largely to
help us become a little bit moreindependent in the medical
practice but to give us againmore of that specialized
knowledge.
I guess when you encompass allthat we do, part of our activity
(11:00):
is you might consider to behands-on, like a chiropractor,
massage therapist.
A lot of our, the bulk of ourinformation is rehab, exercise,
science, and so you're combininga lot of these different
elements then into what is now adoctorate degree.
So, but it's the same, it's thesame entry point.
When we went through themaster's program the knowledge
(11:24):
was generally the same as whatyou're getting from the
doctorate program.
There's three years in thephysical therapy program now,
and so there's just a strongerbase, I guess, from general
studies, getting a bachelor'sbefore you go through your
doctorate program in physicaltherapy.
Tom Butler (11:42):
My thought on that is that over the years, that
physical therapy has really beenseen as a vital, even part of
keeping people functioning well,keeping people healthy, and I
think that when you think aboutyou know a doctorate level
education, it's really sayingthat this, the knowledge is
(12:04):
broad, that a physical therapisthas to have and so you need to
put in the time to turn a lot ofthings, because it is playing a
role in a lot of aspects inmodern medical care.
Denis Beaulieu (12:20):
Correct and there's a lot of different
avenues that physical therapistscan take their practice.
They can be in hospital rehab,they can be in neuro rehab, it
can be an outpatient orthopedics.
There is a broad range ofgeneral studies and then each
(12:45):
therapist can kind of worktowards a more specific avenue,
whatever suits them.
And yeah, there's a lot more toknow.
You might say.
Tom Butler (12:54):
Activity is such a key aspect of longevity and I
think every year it seems likethere's, you know that's
emphasized even more, that youknow inactivity is like the new
smoking and different thingslike that.
That really you know if you'regoing to be healthy longer and
(13:14):
I'm a really specific example ofthat if you want to be healthy
longer, you have to be active,and I'm wondering how you see
the role of physical therapy inkeeping someone active for life.
Denis Beaulieu (13:28):
There's a bit of a struggle with that too,
because when someone comes to uswith a positive attitude about
recovery, getting back toactivity, it's so much easier to
work with that type of a personversus trying to, shall we say,
push someone along intophysical activity, and we've
identified that as a marker forsuccess.
(13:51):
I mean, if you're coming tophysical therapy from an injury
and you're motivated to get backto your sport or get back to
healthful living, even if it'shiking or, in your case,
bicycling, it is so much easierto guide that process versus
someone who has been inactive.
It's so much harder to.
I guess the saying that I useis you can't steer a parked car.
(14:15):
It's very hard to get someonemotivated if they're not already
moving, so that becomeschallenging.
So movement, physical health,keeping active, especially for
longevity's sake, is veryimportant active, or would you
see the majority of people youknow being active?
Tom Butler (14:32):
I mean, we hear statistics that you know only
30% of people are really active.
(14:52):
Would you say that that is whatyou see in your practice?
Denis Beaulieu (14:57):
Well, fortunately for us there's a
pleasant blend.
We have employed a lot ofathletic trainers and so we tie
into the schools a lot, so itseems like on a given day we see
a lot of young athletes.
We see a lot of young weekendwarriors too.
The other interesting aspect ofour practice is we do see a lot
of injured workers, so we do alot of occupational medicine, so
(15:21):
people trying to get back totheir job and their work, but
then there's a significantportion of those that are just
inactive.
I don't know why I started tohave this pain, but I started
having this pain Help me ofactive versus inactive adults
(15:49):
per se, just because if you'recoming to us, you're definitely
going to be working on a injuryor a pain that won't go away and
you have sought medicalattention and you figure that
physical therapy is going to bethe one that helps you.
So it's kind of an unusualblend and of course insurance
drives some of that, but for themost part there is a fair blend
(16:10):
of those that are alreadyactive versus those that are
inactive, Gotcha.
Tom Butler (16:16):
Now, in my case, I was like 59 years old.
I had probably decreased myactivity level for 30 years and
had gained weight for 30 years.
And you know, and at 59, I'mlike, okay, something's got to
be done here.
I had some disease processesthat I wanted to reverse.
(16:36):
So, given someone not havingbeen very active, you know, and
starting out in their 60s or 50s, is there a role for physical
therapy assessment beforestarting being active?
Denis Beaulieu (16:54):
You know, not really.
I think you find most peoplejust simply say, oh, I remember
I liked walking or running orcycling, and they'll jump into
that activity, which is good.
That self-starter mentality isreally what you're looking for
is somebody who wants to getback into activity.
So whether it's a court sportthat you can enjoy with friends
(17:17):
or going walking, just simplystarting is probably key to that
first step getting into youractivity.
So physical therapy doesn'tnecessarily start that process,
but we're definitely there alongthe way.
If injury would happen, say ifsomebody started a walking
program and realized that theywere using poor shoes and ended
(17:39):
up with foot ankle problems orhip problems, that's when you'll
see physical therapy becominginvolved.
We're really down the journeyaway, not so much as an entry,
return to sport or return toactivity type of industry.
Tom Butler (17:54):
The reason that I asked that is because I ended up
developing bursitis.
I was on a ride and it kickedin.
It was the first longer ride Ihad done.
It was actually on my 60thbirthday and I really yeah, so
cycling over 60 kind of that'spart of what created this, and
(18:16):
it was the longest ride I haddone in a long time, and at
about the 50 mile mark I starteddeveloping some knee pain.
It got pretty bad by the time Ihit the 60 miles and I went in
and you know it felt likeeverything pointed toward
bursitis and so so what happenedwith that physical therapy
(18:39):
appointment?
And you know what happenspretty much any physical
therapist that would look at me,you know they'll say, like
touch your toes or somethinglike that, and then they become
pretty much horrified that Ihave so little flexibility, you
know yep and so you know I getthese exercises for flexibility.
(19:05):
The thing is, you know, was Iget these exercises for
flexibility?
The thing is, you know, wasthat something?
It seems like that's somethingthat I could have gone in to a
physical therapist and said, hey, I'm getting ready to be more
active than I've been in thelast you know, easily 25 years,
(19:26):
maybe 30.
Could we talk about some of thethings that might interfere
with me being able to be active,and would they have maybe
checked for flexibility at thattime and said, hey, you know
this is going to be an issue foryou if you're not flexible.
What do you think about thatkind of free activity assessment
later on in life?
Denis Beaulieu (19:44):
Well, tom, that would be a refreshing visit.
I would so enjoy that visitwith you because you know, if
somebody is starting back to anactivity, there is some key
points you can look atFlexibility strengthening.
How much load and how muchprogression do you do?
So there's a couple of ways wecould help.
(20:07):
We could look at thatflexibility, strength and kind
of help you design a morecomprehensive program, I suppose
, than to just go back and seewhat 60 miles is going to feel
like.
But you're also kind of we'rein the middle and I'll give a
shout out to the athletictrainers of the world.
(20:27):
They're underutilized, to behonest.
They're really your performanceexperts when you are going
through a recovery like frombursitis, once you've discovered
that you can, you can't just do60 miles in a in the drop of a
hat.
There is some training andpre-training that you should be
doing, or even cross-trainingyou should be doing as you get
(20:49):
back to an activity when you'rerestarting later on in life.
But athletic trainers, they'reunderutilized, mostly because
they're and this gets into somestrategies mostly because that's
cash out of your back pocket,and this gets into some
strategies mostly because that'scash out of your back pocket.
So you have to actually go seekout a trainer, seek out
somebody who knows your sport orbe familiar with your activity,
(21:11):
and yeah, they probably don'tget utilized as much.
You go to the gym and you say,oh yeah, I get that one athletic
trainer appointment to learnthe equipment, but you can
actually secure their servicesto help guide you through this
return to exercise how much load, what should my nutrition be,
(21:34):
what should I be doing on offdays and how many days should I
train?
So they're really in a keyposition to help.
I would love to do thatappointment and say, oh yeah,
you've got some flexibilityconcerns.
You have some mobility concerns.
You may want to look at theseissues before you jump right
into this sport, but I wouldhave to say let's give a shout
(21:58):
out to the athletic trainers ofthe world and give them a shot.
I love it.
They are the performance guys.
We sometimes miss that spot.
I mean, we are good at it, butwe're good at bringing you from
the ACL injury back to hey.
I think you're ready to go hitthe field and get back to
football or get back tobasketball.
(22:19):
In that mix, though, we reallylike to use our athletic
trainers.
So there's a shout out forthose guys.
Tom Butler (22:27):
Great, and so do you have athletic trainers on staff
.
Is that right?
Denis Beaulieu (22:40):
We do and we use the athletic trainers as much
as we can in clinic, but a lotof our athletic training staff
are also then working at thehigh schools and helping their
athletic programs, which, withthe rise of concussion awareness
, that has been a big job for usas far as helping kids that
have gone through concussioninjuries in their recovery
process.
So we've become part of thatprocess then, with the athletic
trainers being a very key pointof that.
Tom Butler (23:03):
Interesting so yeah.
Now, what do you think aboutcycling as an activity to stay
fit later on in life?
Do you have a professionalopinion about that?
Denis Beaulieu (23:14):
It's a great activity If you think of the you
know load on the joints if youwere to start, say running
versus cycling.
There's less impact withcycling, certainly more ground
to cover, boy, you can get outand see some scenery More than
just the three times around theblock walking.
So there's definitely somegreat aspects to cycling, but
(23:37):
there's also things that wecould talk about too, like the
bursitis issue.
How do I prevent things likethat from happening?
When you go back to a cyclingactivity that is very, shall we
say, linear, it's a forwardmotion.
There's not a lot of variety tocycling.
Your legs and your hips, kindof, are doing that same forward,
(23:58):
forward motion.
So that's that's probably wherewe start to see issues like
your bursitis.
You may need to becross-training a little bit, so
that's that's part of theconcern I guess I would say
between, uh, with any one sport,that you make sure that you're
actually training andcross-training and developing
(24:18):
the whole body, as opposed tomaybe a specific muscle group.
Tom Butler (24:23):
So there's also you know what I've heard a few times
is, the position of cycling issomething that you know, along
with the, the position thatwe're sitting in front of a
computer, kind of bent over infront of a computer, kind of
that combination.
Can you know, cycling does notlike offset or confront or
(24:47):
whatever, that kind of positionproblem.
Denis Beaulieu (24:51):
Right, because you're utilizing the same
muscles that you're going to beconcerned with.
Let's say we're talking about a40 year old who has been
sitting in his office chair foryears.
Their stiffness is going to bealong the same lines of muscles
that you're going to be using asa cyclist.
So the use is really good,because in order to stretch a
muscle, you know that you haveto use those muscles.
(25:13):
So if we want to talk abouthamstrings and hip flexors for
what I call a sitting athleteSomebody who's going to be
behind the desk working on thecomputer, sitting in a chair for
long periods of time, versussomebody who's going to be
starting cycling there are someof the same muscles that you can
(25:33):
work on, but you still want towork on cross-training.
You still want to work on someof the more lateral muscles
instead of just the forward hipflexors and hamstrings.
They share a similar concernand they can help, like you can
use your cycling to help withyour long-term sitting, but you
(25:54):
still want to cross-train.
You still want to utilize someother muscles to support that.
Tom Butler (25:59):
Now on a bicycle.
You know, and it's incrediblewhen you start crunching the
numbers, but you know, like theSeattle-Portland ride, which is
like a 206 mile over two days,you know when you're pedaling at
90, 95 reps per minute and youknow you're doing a lot of
(26:20):
repetitive motion over you knowthe two days of the stp and so
it seems like if there's, youknow, a little bit of alignment
by the time you repeat thatmotion over and over again, then
that misalignment is really aproblem and I found a good bike
fitting to be really importantto me.
But I'm wondering about yourperspective on that.
(26:41):
What do you think about whenyou think of, like the
repetitive motion and getting abike fit to you know, to the
individual?
Denis Beaulieu (26:50):
Yeah, there was.
I know I recall there was somecoursework that came through for
physical therapists on how tohelp with this exact problem as
we look at various sports in ourarea.
You know that was one of thethings that came up.
It's like we should be helpingthis bicycling community with
bike fit, and maybe you couldhelp me know more about that too
(27:13):
, because I would assume thatsome of the bicycle shops that
are selling you their equipmentwould also have some expertise
in that as well.
Do you find that to be true?
Is there a bike?
Tom Butler (27:24):
fit.
I think there's a coupledifferent things that go on.
I think that bike shopsunderstand if people are
comfortable when they're riding,they're going to be happier
with that purchase, be happierwith that purchase.
And so I think there's a layerof bike fitting that goes on,
that like gets you to the pointwhere you feel good on the bike.
(27:45):
But then there's a totallydifferent layer of bike fitting
and I think many of the peopleat that in that place are
physical therapists, wherethey're, you know it's really a
science and they'll use laserguides and everything.
And there's, you know, like adifferent level, and a lot of
(28:07):
times there's a price differencebetween those levels.
But you know that to me thattop level is so valuable that
it's, you know, if you'replanning to spend much time at
all on a bicycle, then it's goodto you know to be at that level
.
Denis Beaulieu (28:27):
Correct yeah.
And I think that's where I wasjust going to say.
I think that's where some ofthe added emphasis could lie.
For physical therapists ingeneral, it's a specialized
market.
For many years I tracked downthe specialized market for golf.
There's a lot of things that wecan do for golf, fitness and
(28:47):
helping to improve the one toolthat most people can change,
which is their body.
You can be fitted for clubs,you can be fitted for grips, but
one of the hardest things toactually change is the physical
body.
So physical therapists havedone quite a bit of studies
there.
It would behoove us, I guess,to spend a little bit more time
(29:10):
for the cycling community toactually take on the training
for the bike fit.
I know that's available to us,but I would say only a few
samples of people that I knowhave actually gone through the
training.
So it would probably suit us tohelp your community of cycling
well into the 60s to be able todo that performance assessment
(29:33):
for you.
Tom Butler (29:34):
Yeah, I think it's an interesting observation, you
know, because I do think there'speople that you know like spend
their time as professionalcyclists and then get done with
that and go, you know, dophysical therapy, training, and
then they become a reallynatural kind of from a marketing
perspective.
They have that advantage to,you know, pull that in, as
(29:55):
they're talking about what theydo, about what they do.
But you know, I would like tosee cycling become so massive in
the United States that you knowthere's more and more need.
And so you know every physicaltherapy clinic would want to be
able to offer that, so we'll seehow that goes.
Denis Beaulieu (30:16):
Yeah, I mean again making our community more
aware of the cycling needs, ofhow to better stay in the game,
if you will, of cycling on yourcommunity.
If we were to spend a littlebit more time making sure we
knew a few specializedassessment tools that would help
(30:43):
your you stay on the bike foryears to come, if you will yeah,
nice.
Tom Butler (30:48):
Now it seems, as I get older, like I have more
aches and pains, you know it'slike just the.
It's just normal to step out ofbed with some some kind of ache
, and so I am wondering you knowwhat would differentiate like
normal muscle soreness after aride versus a potential injury?
(31:12):
I don't know if that questionmakes sense, but how do you, how
do you make that decision that,okay, this isn't normal?
This is something that I needto go seek some attention for.
Denis Beaulieu (31:24):
Yeah, I think most people come to that
naturally.
Basically, if a pain doesn't goaway like it did last time, or
if it doesn't go away in areasonable amount of time with
reasonable efforts ofconservative care ice, heat,
medication over the counter andthose types of things then
(31:45):
you're seeking help.
It's like this is going on waytoo long and that's where we see
a lot of people come intotherapy for an assessment.
It's like I have this pain.
I started getting back into mysport and now I feel like this
is stopping me from my sport.
Help me.
So, yeah, it's, it's those.
It's kind of intuitive, I guess.
(32:06):
If a pain persists and doesn'tget better with your
conservative methods, we'rethere for you.
Yeah, we'll see you in therapy.
Yeah.
Tom Butler (32:15):
Okay.
Denis Beaulieu (32:16):
But there's no magic.
There's no magic to it.
You know.
You know you're going to besore after cycling, I know I'm
going to be sore after playingracquetball or pickleball.
And so you monitor it, you playthrough it, you strengthen
through it and, yeah, if itdoesn't get better, you consult
your doctor, they send you tophysical therapy and we hook up
(32:43):
we hook up.
Tom Butler (32:43):
So you know, I mentioned earlier one of the
things that I always consider isI am very thankful that my
knees are in good shape.
I do have to be careful.
I can get bursitis, but youknow I don't have knee problems.
But that's not really the casefor you, right Like you have
some knee problems, and so Iwonder if you could talk a bit
about that.
Denis Beaulieu (33:03):
So, yeah, I wish I had a great story for my
injury, but it was a longshortcut.
I was trying to cut across afield and it required going down
a steep slope and I twisted andturned and basically tore my
ACL and meniscus as I wasfalling.
That was several years ago andI rehabbed the knee.
(33:25):
I felt I came back to 100%really well and then, just over
time sports applications I wasable to injure it again.
So's, it's been an interestingprocess then for me to stay
active in sports, because I do,like everybody else, uh, working
(33:46):
out, exercising is not nearlyas fun as being out playing,
cycling, uh, playing a sport.
So I, uh I train now or do myown exercise routine so I can
stay out on the court, and thatprocess comes and goes.
There's, you know, again, themonitoring of injury and
swelling and how the arthritisis advancing.
(34:10):
So I have to be a little morevigilant with what I do with my
knee again to keep me happy,going backpacking like we did,
and or staying on the court tobe active and stay healthy.
So it's an interesting processthen, when you're dealing with
that persisting arthritis frompast injury.
(34:31):
That's probably an area wherephysical therapy can really help
the injured athlete, theinjured adult who wants to stay
in their sport.
How do you strategize throughsome of that?
What do I do?
Now?
It's really kind of the bigquestion we hear.
I think that's where you cansee physical therapy really help
you with the strategy.
A lot of people are afraid toexercise because they have
(34:52):
arthritis.
They have this diagnosis now ofarthritis.
Well, one of the best things isgetting education.
What does that really mean foryour knee or for your hip or for
your shoulder?
It doesn't mean you stop allactivity and unfortunately, a
lot of people do believe theystop activity.
So we're the proponents thatwould help you get back to the
(35:13):
activity, learn what arthritisreally does for your body and
how you can support that so youcan stay active.
Tom Butler (35:21):
I think it's more fascinating that you did this
injury just in some like mundaneactive.
You know average activity, Imean I think it says something
about how we can get injured.
It's not you know, if you'renot being active, you know you
(35:43):
can just as easily maybe notjust as easily, but you can
injure something in a mundaneway.
Denis Beaulieu (35:51):
Oh for sure, I mean home injuries.
Home accidents, that is really.
We see a lot of those types ofinjuries.
It's not all car accidents insports, some of it's just the
silly stuff we do.
I went out and stepped out ontomy back porch and slipped on
the ice and now I have an injury, so it can be just as
(36:12):
pedestrian as that.
Not every story comes with thegreat sports injury where I was
going up for that winning shotand got hurt.
So most of us do get hurt in somany boring ways.
So now, that's that's where wefind everybody.
That's where we find, uh, youknow, the, the avid cyclists
(36:33):
such as yourself.
Uh, might, it might be adifferent injury that you
incurred.
Tom Butler (36:38):
Yeah, when you look back at it, do you think there's
some things that you could havebeen or should have been doing
that would have prevented thatstress from leading to damage?
Or is it just that things?
Denis Beaulieu (36:57):
like that can just happen.
No, for me it was justsomething uh, it's something
that could happen.
Um, maybe I should not havetaken the shortcut, but I did.
I mean, I'm young, healthy guy,I can go through this field.
Injuries and accidents, theyhappen, uh, to all of us.
Really.
There's no way to prevent that,maybe being a little bit
(37:18):
smarter.
But I think we all come to thatpoint where it's like, well, I
thought I could actually do thatactivity and I guess now I
can't.
It can be as simple as walkingout on your front porch or I was
out line dancing with myfriends and twisting an ankle.
Well, there's no way to preventthat.
(37:38):
So we're, all you know, victimsof gravity, I suppose.
Tom Butler (37:43):
That's a very good point.
Victims of gravity, you know,until we have those full body
airbags that just inflate, youknow, whenever you start going
down or something I don't know.
Whenever you start going downor something I don't know, when
you had your injury, I'mwondering what thoughts went
through your mind.
Did you feel like you knew whatto do?
(38:06):
Did you feel like you learned alot about rehabbing something
in that process of dealing withit yourself?
Denis Beaulieu (38:15):
What's your perspective there?
Well, what's really interestingis that I was actually
diagnosing my injury as I fell.
My foot went into a hole and itstarted twisting as I fell
forward.
I'm like, oh no, I just tore myacl and meniscus, you know it
was.
It was kind of surreal, Isuppose.
On you know it's like is thishappening?
(38:35):
Happening?
Yes, it happened.
And then, of course, I go to mybuddy and I'm like, all right,
test my knee.
I know I tore my ACL and so mybuddies would test my knee and
I'm like, oh, I guess it's notso bad Initially, I just tore it
.
And then, five weeks later inmy rehabilitation, I forgot that
(38:56):
my knee was injured.
We had done so well atrehabbing my knee and five weeks
later I jumped off of a it wasa little partition wall at
Multnomah Falls.
I jumped off of the wall backonto the trail and completely
finished rupturing my ACL.
So, insult to injury.
(39:17):
And yeah, that was the amazingprocess.
I'm like, oh man, I did it.
I forgot my own injury and Iinjured it again.
So, yeah, even as smart as weare in the rehab industry, we're
all stupid when it comes toinjuries.
I suppose, uh, but you know,self-diagnosed.
My family was like, oh, oh, no,we need to take you to the
(39:37):
hospital.
And I was like, well, I tore mymeniscus and my acl.
I finished rupturing that.
So let's just put me down hereat the bottom of the hill.
You guys finish your hike,enjoy multnomah falls.
I'll see my doctor on monday.
So I guess that's the addedexpertise that I had.
I got to self-diagnose but, um,you know, I still had to go
(40:00):
through the rehab.
Once I finally got the surgeryto, decided to have a surgery to
re uh, to repair the ACL, Istill had to go through the
rehab.
I still needed guys to help me.
So I couldn't do it.
I couldn't move my leg.
So I had a really good crew andkind of knew what to do.
But, to be honest, even whenyou're a client or a patient,
(40:23):
you still need that help.
Even if you know all theinformation, you can't do it all
by yourself.
So that is where physicaltherapy does shine.
That's where we come in.
Tom Butler (40:32):
You talked about surgery.
It doesn't sound like in thatcase there's a decision to be
made when you totally tear it.
There's not really a decisionmade about whether or not to do
surgery.
Is that correct?
Denis Beaulieu (40:46):
Well, not really actually.
In fact, the doctors in my townwho had been sending me their
ACL reconstruction clients hadbeen sending me their ACL
reconstruction clients.
All three doctors that I wentto were telling me to not do the
surgery because we're decidingthat we're just going to let
people get strong and we'll seeyou later down the road.
(41:07):
Anyway, for me, I was still inmy 20s, still felt I had a lot
of sport and game to play anddidn't want to stop there, and I
knew what a non-surgicalruptured ACL looked like 30
years, 40 years later, because Ihad been treating those clients
(41:28):
too.
So I actually had to go outsideof my health network and find a
doctor that would treat my kneeand do the surgery.
Now it was the most bizarremoment of the whole thing for me
as a rehab specialist that mydoctors did not want to do rehab
or didn't want to do thesurgery on my knee.
So I guess I really wanted thesurgery because I knew that I
(41:51):
wanted the performance out of myknee later on in life and I
would say I made the rightdecision for me.
There may be something differentin the decision process for
somebody who well, let's talkabout bicyclists Do you
necessarily need an ACL forcycling?
And I would say not really.
(42:12):
If you're youth over 50 and youdon't want to go through the
surgery of getting an ACLreconstruction, you could
probably do quite well ifcycling was your primary sport,
because then you can work onstability and control of the leg
in the absence of an ACL.
So there are some options forpeople and you still have to
(42:32):
make that decision with yourdoctors, sometimes with second
and third opinions with thedoctors, but there there is
still that opportunity to gothrough and repair something
that has been broken a brokenbone, a broken ligament, muscle
that gets ruptured.
Each one of those, in each oneof those cases, has their own
(42:55):
unique features and and you haveto then take that case by case,
person by person, and reallyconsider whether that surgery is
important or not for you.
So that's a big decision.
That's usually one that you'rereally involving your doctor.
Of course, everybody asks theirfriends did you get the surgery
(43:16):
?
Yeah, I got the surgery, or no,I wouldn't do that, I would
never do that.
So you have to weigh all thisinformation.
Now, as somebody who's seekingmedical attention, what do I do?
So?
But I think the medical fieldis good at helping you process
through that, and the rumor millis good too.
You can ask your friends, youcan ask your buddy hey, you went
(43:39):
through that surgery.
Should I do it?
And that's not the best advice,but it is still the advice we
seek, isn't it so?
Well, it's, it's, it's probablynot.
Tom Butler (43:50):
It's probably not bad advice.
Taking in an aggregate of a lotof different advices, it's like
, okay, what did you go through,how did you experience that?
And you add that to maybe someinternet research and to some
medical advice.
That's taking into account yourpersonal situation, so you know
(44:10):
as a you know, again as a piece, but maybe not the only source.
Denis Beaulieu (44:17):
Yes, correct, correct, yeah, and physical
therapy actually becomes part ofthat process.
Can we conservatively treatthis injury and not do heroic
surgery?
Can we let the body heal if wesupport it with proper activity?
So we do see a fair number ofcases in that category where,
(44:38):
okay, you might have strained ortorn part of the rotator cuff.
Do you really need surgery?
Well, let's explore that so webecome a really interesting part
of that process for you whenyou're considering your injury
and considering yourrehabilitation.
Will I be complete or will I beto the position I need to be to
(44:59):
continue doing what I want todo in life?
So it's a really nice avenuefor what we do in physical
therapy.
Tom Butler (45:06):
So you are again staying active.
You have knee pain and yetyou're throwing a backpack on
and going hiking.
Can you talk about that processin your mind?
Because, again, you know morekind of what's potentially going
(45:27):
on than maybe the averageperson.
And so what's that thoughtprocess in your mind about
staying active and about painand being active and the
different layers of decisionsthat go on for you to be active?
Denis Beaulieu (45:43):
Yeah, fortunately I can speak well to
it because I did what everybodyelse did in life.
I had my ACL injury early inlife, went through the rehab.
I had an interestingperspective one day when I went
to do an activity and realizedthat maybe I wasn't at 100%
anymore.
I went to climb a telephonepole at one of those adventure
(46:08):
parks where you are climbing anddoing the high ropes adventures
, walking across the cablebridges and things like that.
So one of the last events wasclimbing a telephone pole and
standing on top of the telephonepole and I realized I couldn't
take that steep step with myright knee and so that was a
(46:29):
little bit of a shock todiscover that I wasn't as
bulletproof and maybe not at100% like I thought I was, that
I wasn't as bulletproof andmaybe not at 100% like I thought
I was.
So that processing then kind oflearning through life, that my
sedentary moments kind of tookme on my own little journey with
my knee and my knee did not dowell if I was sedentary.
(46:50):
As soon as I got back intoactivity, went through
strengthening, conditioning,participated in my sports, I was
able to actually feel better.
My knee would respond better today-to-day activities as well
as the sport activities.
So it's been a reallyinteresting learning process for
me to enjoy exercise and toenjoy training and getting my
(47:14):
knee back into a satisfactoryposition, a satisfactory
condition to help me stay activeand stay healthy.
So it's been quite a journey.
We'll often tell our clientsthings like you know, for your
arthritis, motion is lotion.
So we have all these littlesayings.
But it really is about how thebody responds.
(47:36):
If you maintain an active,healthy lifestyle, your body
will have the tendency to healbetter.
It'll have the tendency torecover, shall we say, faster,
or recover at least to a betterposition if you're active.
If you're inactive, there's somany more problems that we have
to deal with just in rehabbing,let's say, your knee.
(47:59):
There's more that we have toconsider Now.
We have to look at your ankleand your hip and your back and
everything else that goes alongwith that.
So I think the real drivingpoint of this discussion is
activity is so important forlongevity, muscle mass is
important.
Longevity is so important forlongevity, muscle mass is
(48:19):
important.
So you need to be engaged inactivities that will improve
your muscle mass for longevity.
One of the research pieces thatI came across recently was one
of the best predictors oflongevity was actually muscle
mass.
That was kind of a shock,really, because you would think
that there would be other healthbenefits that would go along
(48:40):
with that, like maybe heart rateor blood pressure, blood sugars
and all those.
But one of the betterpredictors of longevity is
muscle mass.
So that takes us right back toactivity.
How do we stay active, how dowe engage in this so that we can
continue our sport, ourrecreation, the real stuff that
brings us joy in our life?
Should we say so?
(49:09):
It's been an interesting journeyfor my own personal need that I
can actually then share with myclients, because you know
they're struggling, they'rethinking I'm never going to get
back to work again, or I'm nevergoing to get back to hiking
again.
Work again, or I'm never goingto get back to hiking again.
It's like, well, let's try itand see, because you don't know
what this process will be.
Let me share my experience andlet's help take you through your
experience to see what you canget back, and I think that's
really been.
(49:30):
Some of the joy in physicaltherapy is seeing people recover
from what they might havethought to be a sport ending or
a event ending injury.
There was one client inparticular who was halfway
through training for a marathonand they injured their body and
(49:50):
thought, oh, I'm never going toget to that marathon that I'd
signed up for.
And we were actually able toget them through that process
quicker than they thought, backinto the training circuit and
able to go to that marathon.
So it was really kind of a neatprocess seeing someone go
(50:10):
through that higher competitivelevel of training, have a
breakdown, get them back totheir training level before the
event.
So that was probably one of themost rewarding events ever and
you know how marathons arereally tough on the body, so
that was very satisfying to seethis client go through that
process.
(50:31):
So I think there's some of thatfor everybody.
Tom Butler (50:34):
I love that story and I love what it says about
the power of the body to heal,right, right.
If you look at structuring aprogram that works with the
body's ability to heal, there'samazing things that you can do,
and I think the really importantnews for someone like me is
(50:56):
keep going, find a way Even ifthere's an injury.
You know it might slow you downa bit, but figure out how to
keep moving, keep being activeand connect with someone like
yourself who has professionalexperience with that, and then
comply with what you say.
Denis Beaulieu (51:20):
Well, right, that's the other corner of that
little piece of the puzzle.
Compliance is tough.
I don't want to do thisexercise.
I wasn't doing it before and Iwas fine Helping people see that
some level of activity whetheryou were inactive before or
highly motivated before, thereis a dosage of activity that
helps you rehab and helps youget better, helps you improve,
(51:42):
helps you recover from an injury, and that's where it really
does take a professional.
It takes somebody who knows orhas maybe seen a few of these
before, to help you through thatprocess of recovering from your
bursitis or aches and painsthat just don't seem to go away
and they're hindering my sport.
We've seen it before.
(52:03):
We can help you through thisprocess.
So that is the pitch forphysical therapy.
When it comes to cycling over60, I guess is let us help you
where we can and maybe seebeyond the hedge that's in front
of you and help you breakthrough some of those ideas and
concepts that may be preventingyou from wanting to continue
(52:24):
cycling or whatever sport youchoose.
Tom Butler (52:26):
Yeah, I like that Well.
Dennis, thank you so much fortaking the time.
I really appreciate youbringing your perspective, both
as a professional and then assomeone who has his own journey
as far as being active, and Ijust think that it's valuable to
get the combination of thatperspective.
(52:47):
And thanks again for coming on.
Denis Beaulieu (52:49):
Oh, it's been my pleasure, and you've actually
kind of sparked some interest inmy mind as well about how do we
help these cyclists in theirpursuits, so I appreciate that
as well.
Tom Butler (53:00):
Nice, all right, talk to you later.
Denis Beaulieu (53:03):
All right, goodbye.
Tom Butler (53:04):
Bye now.
Here's the biggest takeawayfrom that discussion for me.
I think I can worry less abouta knee injury taking me off the
bike for an extended period oftime.
Sounds like many people recoverwell enough to keep going in a
(53:25):
reasonable time.
But once again I heard afamiliar message from Dennis.
I need to think aboutcross-training.
I'm really not attracted to theconcept of cross-training Plus.
I'm doing some cross-trainingalready in the upper body
workouts I do.
I do think maybe I need tospecifically seek out some
activities that can generatemore lateral movement than what
I get from the pedaling motion.
(53:45):
So off I go again on anotherjourney.
This one discoveredcross-training.
That isn't boring.
I would love to hear if youfound a form of cross-training
that you enjoy.
You can find my email in theshow notes or, for a quick way
to message me, click the send mea text message link at the top
of the episode description.
I'm getting excited that warmerdays are coming to my part of
the world.
I will welcome a day to get outin short sleeves and shorts.
(54:08):
I hope, wherever you are, youwill have some great weather to
ride in as soon as possible.
And remember, age is just agear change.
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