July 13, 2025 • 26 mins
Motion is Lotion: The Power of Physical Therapy with Erin Osmus
Join us on Peaceful Life Radio as we welcome physical therapist Erin Osmus, who shares valuable insights on the importance of exercise, particularly in the latter half of life. Erin, holding a Doctorate in Physical Therapy and with 27 years of experience, talks about the benefits of resistance training, cardiovascular health, and flexibility. She also discusses the psychological benefits of exercise, prehabilitation strategies before surgery, and effective recovery methods post-surgery. Don't miss this informative episode filled with practical advice to help you lead a healthier, more active life.
00:00 Introduction to Physical Therapy
00:31 Meet Erin Osmus: Expert in Physical Therapy
01:51 Importance of Exercise in Later Life
02:43 Psychological Benefits of Exercise
04:15 Pre-Surgical Preparation and Prehabilitation
11:01 Practical Exercise Tips for Seniors
12:20 The Role of Physical Therapy in Pain Management
14:23 Post-Surgery Rehabilitation
23:40 Conclusion and Key Takeaways
Visit the Peaceful Life Radio website for more information. Peaceful Life Productions LLP produces this podcast, which helps nonprofits and small businesses share their stories and expertise through accessible and cost-effective podcasts and websites. For more information, please contact us at info@peacefullifeproductions.com.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Erin Osmus (00:00):
So I always tell my patients, motion is the lotion.
(00:02):
Start moving.
Exercise comes in all forms.
It's not just the gym.
It's not CrossFit.
It's not necessarily RichardSimmons or whatever.
It doesn't have to be yoga.
It can be a resistance band.
It can be walking yourneighborhood with your wife.
It can be taking your dog for awalk.
It can be taking the stairsversus the elevator.
While you're waiting for thatfive minutes for that coffee to
perk, there's not any reason youcan't, raise your heels, go up
(00:23):
on your toes.
Can you stand while you'remaking coffee?
Can you do 10 mini squats whileyou're waiting for that, Keurig
to run through?
David Lowry (00:31):
Welcome to Peaceful Life Radio.
That was physical therapist ErinOsmus, this is David Lowry, and
with me today is my good friendDon Drew.
Don, how are you?
Don Drew (00:40):
I'm doing great.
David
David Lowry (00:41):
Don.
I wanna hear more about Erin,tell us about her.
Don Drew (00:45):
Absolutely.
Our guest today is Erin Osmus,who holds a Doctorate in
Physical Therapy from BostonUniversity and is currently an
active physical therapist in theMercy Hospital system, and she
has 27 years of experience.
Erin focuses on jointreplacement, stroke rehab, and
head injury rehab.
She practices what she preachesmaintaining a healthy lifestyle
(01:05):
and daily exercise routine.
I first got to know Erin lastyear when I visited her after
tearing the rotator cuff in myright shoulder.
She helped me rebuild thestrength in my shoulder before
surgery so that postsurgicalrecovery went really well and
very quick.
Today Erin is going to talk tous about how we can better
prepare ourselves for impendingsurgeries and work with a
(01:27):
therapist to recover as quicklyand effectively as possible.
Erin Osmus, welcome to PeacefulLife Radio.
Erin Osmus (01:34):
I'm glad to be here, guys.
David Lowry (01:35):
Erin, first of all, I think you did a great job on
Don's shoulder, but I waswondering if you could take care
of that big hump in his back?
Erin Osmus (01:44):
Well, don't think I can do that.
Don Drew (01:47):
I'm gonna get you for that, David.
I'm gonna get you for that oneErin.
I wanna start off with askingyou about general fitness and
the importance of exercise inthe second half of our lives.
Erin Osmus (01:57):
Exercising the second half of your life is
super important.
We need to start with resistancetraining.
As you all know, the older weget, we're prone to
osteoporosis.
We need to build bones.
The best way to do that, reallyto prevent it, needs to start in
your thirties, but if you wannastave it off, usually by your
fifties, you need to startthinking about anything that's
resistant.
But I'm not talking about, youdon't have to hit the gym.
It doesn't have to be heavy, bigweights and dumbbells.
(02:19):
But as you know, from when youand I worked together,
resistance bands, that's superimportant.
Your cardiovascular health isvery important to fitness in the
second half of your life.
The later stages in our life westart facing neurological
deficits.
We have high risk for falls.
The stronger we are, thestronger our core is, the more
important it is for flexibility.
Obviously you wanna minimizemedications and minimize doctor
(02:42):
stays.
Don Drew (02:43):
What about the positive psychological effects?
Erin Osmus (02:45):
There's huge psychological components in
exercise.
Anytime we exercise, we're gonnarelease endorphins, serotonin
levels in our body, which wemake inside of us, which
synthetically areantidepressants and happy pills,
so to speak.
The more you exercise, you canrelease all of that.
I'm a big proponent.
I exercise every day.
Have you ever heard the wordrehab junkie?
(03:06):
The more you exercise your bodystarts producing these
endorphin, starts producingthese serotonin levels and we
start to crave it.
I can't go to sleep.
I can't rest if I haven't workedout.
Like, I just don't sleep good.
I miss it and people crave it.
So psychologically, the more youwork out, the happier you are.
David Lowry (03:21):
Erin, it sounds to me like if we had to put it into
categories you're going to needsome strength, physical
strength, so we do someresistance training.
You need cardiovascular health.
And then flexibility is a goodidea, right?
Erin Osmus (03:36):
Absolutely.
David Lowry (03:36):
And then all of that together has a synergistic
effect on not only your body,but also your mental health.
Erin Osmus (03:44):
Absolutely.
Let's think about the moreactive we are, the more that you
can do, the better off you areof physiological.
If you physically can't climbthe stairs, there's, it's a
devastating effect of that.
If you can't walk a householdambulation, you can't go places,
you can't do things.
Your world becomes smaller.
The more fit you are, the moreactive you are.
And you don't have to runmarathons, but you wanna be in
good enough shape to be able toenjoy dinner, go to church and
(04:05):
park in the back of the parkinglot if you can't find a close
space.
You wanna be able to go to thetheater.
You wanna be able to do thingsthat your body can physically
tackle without being a burden toyou, your family, or whatever.
Don Drew (04:15):
One of our goals today is to focus on pre-surgical
preparation and how to rehabourselves after surgery.
Let me just ask you, in terms ofpre-surgery, if we know that
we've got a surgical procedurecoming up, in which we're going
to be needing some kind ofrehabilitation, what are the
most important things a personcan do physically to prepare
(04:37):
their body for that surgery?
Erin Osmus (04:38):
Obviously it depends on, if it's a joint replacement
or kind of surgery you'rehaving, but the better shape
you're in going into any kind ofsurgery, obviously the better
off you are.
So I made myself some noteshere.
A lot of times people will havetherapy, kind of a last ditch
effort to prevent surgery.
They'll go to physical therapy,have therapeutic interventions,
which will then decrease therisk of having to have the
(05:00):
surgery.
Well, the stronger you are goinginto that, obviously the better
off you're gonna be.
I tell people the thing thatthey really need to think about
is that you need to beproactive.
At Mercy, we're starting to getthis trickle down effect with
physicians to send people to PTas a protocol prior to surgery,
we call prehab, so that they cango and meet with a therapist,
kind of figure out what's gonnabe their plan.
(05:22):
Are they gonna go into surgeryand then go to home health?
Are they gonna go to outpatient?
What is their home situationgonna look like?
What are they gonna need?
A lot of times you, yourselfwill know you come outta surgery
and there's not a lot you can doin the very beginning, but there
are some isometric exercises youcan do, some things that would
help you immediatelypostoperatively before you get
to the therapy sessions.
(05:42):
And we would like to be able tohave that kind of intervention
with people right off the bat.
So my supervisor and I areeducating physicians and getting
them to let us get our hands onpatients before they even get
into surgery.
Think about it.
If you can meet your therapistprior to that surgery, when you
come out, you know what toexpect.
Psychologically you are gonna bea lot less nervous.
You're gonna be a lot lessapprehensive.
You are gonna know what toexpect.
(06:03):
You can picture what this isgonna be going into that.
Don Drew (06:05):
I'm glad you brought that up because I remember in my
case what happens when I visitedmy physician and he thought I
would need surgery, but I wasn'table to have it for a
significant period of timebecause I already had a couple
of big hikes.
And these are like internationaltrips already planned.
So I needed to follow throughwith those first.
So I had a twofold goal.
One was to get myself ready tohandle the hikes, and then
(06:31):
following that to prep forsurgery because I pushed surgery
out so far.
Erin Osmus (06:35):
And like I tell a lot of patients, I'm not gonna
fix your rotator cuff.
Obviously that's torn.
But what we can do is we canstrengthen all the muscles
surrounding it.
Joints above and below.
So if it's your knee, we wannamake sure your hips and your
ankle are super strong.
If it's your shoulder, we wannamake sure you've got good
cervical range of motion.
Wanna make sure your elbow andyour hands are in good shape.
And we can have you going intothat so all the surrounding
(06:55):
tissue and the surroundingmuscle are in the best shape
that it can be before you gohave that surgery.
We can do a lot of strengtheningprior to going in so that you're
prepared.
I've had several patients,they're like, Hey, I've got this
big trip to Europe planned.
Like I don't wanna have thisknee surgery until, I have more
vacation in the winter.
Let's get those quad muscles asstrong as possible.
Let's get your cardiovascularshape in so that you can
(07:16):
tolerate and do a lot morethings.
If you're not fantastic shapeand barely making it to the
mailbox, what's it gonna be likepostoperatively if you're on
crutches?
So being in the best shape thatyou can prior to that is only
gonna help you.
David Lowry (07:27):
So this prehabilitation you're talking
about, is this mostly forjoints, or for other conditions
as well?
Erin Osmus (07:35):
Well, it's funny that you say that.
I, myself just had surgery thispast spring and I'm very fit.
I work out every day.
It was kind of an unexpectedthing, but I knew I was going
into it probably two monthsbefore, and I just asked my
doctor, Is it safe?
Can I continue to work out?
She was like, absolutely.
Literally the day before I hadsurgery, I did a 10 mile ride on
my Peloton and had surgery thenext day.
(07:55):
I could barely walk to thenurse's desk, which I laughed
about and I thought, this isreally tough and look how good a
shape I'm in.
I don't know if I'd have evenbeen able to get out of bed if I
hadn't been working out prior tothat.
In my recovery, they tell me,Oh, it'll probably take you six
months before you're back.
Hundred percent.
Well, I'm about three months outand I feel great.
David Lowry (08:12):
Wow.
Way to go.
That's an important thing.
I never heard aboutPrehabilitation.
So Don, this is a really goodthing to learn about on our
program because I suspect quitea few people in the second half
of life are going to need thatkind of information.
Don Drew (08:25):
I had a question for Erin about how far in advance of
surgery someone should beginworking with a physical
therapist.
But I was also reminded that notall insurance will cover people.
So I think part of my questionis not just how far in advance
to surgery, should someone beginworking with a physical
therapist, but if they can't,what are some strategies perhaps
(08:46):
they can do on their own?
Erin Osmus (08:48):
A lot of times you can ask your physician.
There are some doctors that arepretty good that have some
handouts.
They have some worksheets.
That's the thing that mysupervisor and I are doing some
research so that we can posethis to insurance companies
because not everybody canphysically get to therapy.
Not everybody has the financialmeans or insurance to cover it.
But talk to the physician.
Say, Hey, what do I haveavailable to me?
(09:09):
What's safe for me to do?
A walking program is a goodplace to start.
A lot of my patients they'relike, I can't walk that far?
Can you walk to the mailbox?
Start with that.
Can you walk to the end of theblock?
Start with that.
If you're safe to do so, ifweight bearing is tough for you,
then try an exercise bike.
I like recumbent bikes for thesecond half of our life.
I'm a big proponent of those.
I like good back support.
It's non-weight, it's closedchain, so you don't have the
(09:31):
impact of walking or running.
A lot of local gyms, a lot ofMedicare and several different
supplements will pay for silversneakers.
A lot of times you can go into agym and say, Hey, are there any
options with my insurancecompany that some of this will
be funded?
You can get a trainer you canwork with, and some of that's
paid for.
We just have to be proactive.
It's your health.
You gotta ask questions.
(09:52):
And I take for granted theknowledge I have.
My mom and my brother are boththerapists, but we were talking
one day years ago about how theknowledge we have, we feel like
is such common sense.
We're like, everybody shouldknow this.
But everybody doesn't know this.
And a lot of times physiciansoverlook and assume that people
know.
So you have to ask, Hey, what'sout there for me?
What's available?
Can I go to therapy?
Can I try that before surgery?
(10:13):
Is that an option for me?
David Lowry (10:14):
While we're talking about being proactive, I'm one
of those people who don't knowvery much about physical
therapy.
Do you have to have a doctorrecommend you?
How does one get into physicaltherapy in the first place?
Erin Osmus (10:26):
You need a physician's order to get into
physical therapy.
You need to check with yourinsurance.
Obviously, there's cash pay.
You can pay if you have themeans if your insurance doesn't
cover it.
But most people, your insurancewill cover physical therapy.
You need a physician's order.
Any doctor can write it.
A PA, a Nurse Practitioner, itdoesn't have to be an ortho, it
doesn't have to be some bigspecialist.
Most general practitioners willwrite you an order for physical
therapy.
You just have that referral sentto whatever clinic is close to
(10:48):
you that does what you need themto do.
And they'll call and set up yourappointment.
I do tell patients don't fallthrough the cracks.
If you're supposed to havephysical therapy and nobody
calls you.
Follow up.
You gotta take control of yourown health.
David Lowry (11:00):
That's the truth.
Let's ask a question aboutexercises that you think we
probably ought to all be doingto help us in the second half of
life to maintain this goodphysical health that you're
talking about.
Erin Osmus (11:11):
I believe people hear the word exercise and they
think, Oh, it's a CrossFit Gym,or it's, oh, it's Richard
Simmons.
Or, oh, I have to be in thisformal setting.
It absolutely doesn't.
There is so much out there.
We have so much information.
I'm a big proponent of Pilates.
I like it.
It's a lot of core strengtheningfor people.
It's resistance training.
You don't need a lot ofequipment.
(11:32):
You can Google Pilates and itcomes up with lots of different
things.
It's wonderful for spines.
People have a lot of back painand a lot of back problems.
It's a lot of corestrengthening.
Strengthening your core is agreat place to start.
People, if they have bad knees,they can't walk.
Like I said before, I lovecycling.
I think a recumbent bike isgreat.
If you don't have a lot ofequipment, you can do a complete
(11:54):
workout with a resistance bandyou can buy at Target or Walmart
or Dick's.
If you come to physical therapy,we'll give you one for free.
Resistance is super important.
I'd like to see that because itbuilds better bone health versus
an open chain workout, like abicep curl or such.
If you don't have weights, youcan use a water bottle.
It's, 16 ounces.
All the time tell my patients,start with a can of soup.
(12:15):
Start doing some bicep curlswith a can of soup.
You can get some resistance.
It doesn't have to be rocketscience.
Don Drew (12:20):
You mentioned pain, Erin, I wanna ask if it's
possible that physical therapycan help reduce the need for
pain medication after surgery?
Erin Osmus (12:28):
Pain management is a huge part of physical therapy.
We have modalities, you haveheat, you have ice, we have
movement, manual therapy.
Pain management is huge.
And obviously you come outtasurgery, lots of people on
narcotics, postoperatively, butthe less time you're on pain
meds, the better for your wholebody in general.
You get lots of secondaryissues.
So I always tell my patients,and you've heard this before,
(12:49):
motion is the lotion.
Start moving.
You're gonna start feelingbetter.
A lot of times we have poorposture.
Even with our joint replacementsI do a posture alignment on
everybody.
The first thing I do is, let'slook at your posture.
And they're like, Well, I'm herefor my shoulder.
Yeah, but let's talk about that.
If your shoulders all rolledforward because you've been a
desk job your whole life let'sget yourself in better posture.
David Lowry (13:07):
A question I have, Erin has to do with walking
versus running.
Can you clarify the role ofwalking and running as a form of
exercise for seniors?
Erin Osmus (13:17):
Sure.
To each their own.
Running is gonna be hard on yourjoints because it's gonna be
high impact.
So every time your foot hitsthat concrete, think about all
the force that goes up throughthat ankle, up through that
knee, up, through that hip, upthrough that spine and every
vertebrae of your spine.
But lots of people run well intothe later stages of their life.
Walking and running.
Either one.
You wanna get your heartelevated.
You wanna get your target heartrate.
(13:38):
You can Google target heartrate.
It's like two 20 minus your age.
It's all at an individual basis.
If you're trying to lose weight,walking actually is gonna
probably burn more calories.
I tell patients that and theynever believe me.
Oh, I should be running.
Not necessarily.
You wanna get 20 minutes ofwalking or 20 minutes of running
to hit a good aerobic, to getgood cardiovascular effects.
You gotta start somewhere.
(13:58):
Not everybody can go out andwalk 20 minutes or run 20
minutes.
I always tell patients, Startwith what you can do.
Start with five minutes andincrease, two minute intervals
at a time to be safe.
David Lowry (14:07):
I'm one of the fortunate ones who has a wife
that loves to get up every dayand we walk and solve the
world's problems for 45 minutesevery day.
Erin Osmus (14:15):
I love that.
That is fantastic.
And walking, I can tell patientsif you do nothing but walk, it's
so good for you.
You get your arms pumping, getmoving.
Don Drew (14:23):
Let's turn our attention now to post-surgery.
Right?
We, so we've gotten ready forthe surgery.
We've done what we can tostrengthen ourselves, say it's a
joint, and we've done what wecan to strengthen the muscles
around there and our enduranceand we're feeling pretty good
about where we're at going intosurgery.
We're now out of surgery, and,of course, we're hurting.
At first we're on some prettyserious drugs usually.
(14:45):
And you wanna, try and tailoryourself off that as quickly as
possible.
But nonetheless, you wanna bestarting your physical therapy
within, I don't know, what is itabout, anywhere from a few weeks
to a few months.
The hospital's gonna want you tomove right away.
Erin Osmus (14:59):
When I worked inpatient, I got knees and hips
up day one.
They came out of surgery thatmorning, I was walking them that
afternoon.
Don Drew (15:05):
What is the typical or average situation look like for
somebody coming out of surgery?
They're out a couple weeks to amonth.
They're gonna see a physicaltherapist for the first time.
What's gonna happen?
Erin Osmus (15:16):
Usually when a patient comes home, depending on
the level of assistance and howmuch support they have at home,
a lot of these surgeries used tobe, you would stay in the
hospital for sometimes a week.
Now these are outpatientsurgery, so you're going home
immediately.
A lot of patients are gonna gethome health.
They're gonna have a home healththerapist come into the house.
If you're up and going and yourdoctor says you're ready for
therapy to get into anoutpatient setting, but some
(15:38):
patients have home health and atherapist will come into their
home and do some therapy.
It's minimal.
They're just kind of gettingthem moving.
Usually by week two, dependingon the joint or whatever,
they're coming into theiroutpatient setting.
They've made an appointment.
There's usually a little bit ofpre paperwork to come in.
They're gonna meet thattherapist and then get an
evaluation.
An evaluation's gonna consist ofmeasuring.
If it's the knee, we're gonnasee how much can you actually
(16:00):
move it?
How much can I actually move it?
How much pain are you gonna bein?
They're gonna ask you to rateyour pain zero to 10, zero being
no pain, 10 being I need to goto the emergency room.
They're usually gonna give you ahome exercise program.
Move it around a little bit andthen we're gonna talk about your
pain management.
Are you using ice?
Are you icing it rightreligiously at home?
That's a naturalanti-inflammatory.
(16:22):
Let's make sure we're doing it.
You, you've got lots of edema.
Those are the kinds of things wewanna get you out of.
Then we're gonna set upappointments.
And each time it's gonna build.
So depending on the protocol,the physician, so obviously as a
physical therapist, I work underphysician's orders.
So they're gonna have a protocolfor their expectation of
movement.
With each stage we're gonna moveyou a little bit more.
We're gonna assess your pain.
The general rule of thumb isthat the more you're moving, the
(16:44):
less pain you're gonna be in.
Don Drew (16:45):
What I hear you saying is that as a therapist you are
going to be an evaluating eachpatient individually and
designing a rehab program basedupon how well they're doing,
what their pain levels are andso forth.
So everybody's gonna be treateda little bit different.
There's not necessarily a singleprotocol for all people who have
had shoulder surgery?
Erin Osmus (17:03):
No, the movement is the same, but what they wanna do
is completely different.
I mean, I have a patient that,he's a truck driver.
He has to be able to get up andinto that truck.
So guess what we're doing?
We're working on steps.
We're working on how he can pullhimself up.
We're gonna work on compensatorystrategies if he's right-handed,
and really needs to be able touse that right hand.
Okay.
We're gonna have to startstrengthening this left hand a
little bit.
Every patient's different.
If this patient's like, Oh, hey,I take care of my elderly
(17:25):
husband.
I need to be able to get homeand be able to do this for him.
Every single person isdifferent.
And it doesn't matter what mygoals are for you, what matters,
what your goals are.
So you want your physicaltherapist to ask you, What are
your goals?
That's the most important thing.
What do you wanna accomplish outof this?
I need a buy-in.
I'm selling this to you.
You're walking in that door andI have all these things that I
need you to be able toaccomplish.
(17:45):
But if you don't believe in whatI'm telling you, and you don't
believe that it's gonna work,you're not gonna do it.
Basically with physical therapy,it's 20% that therapist, and
it's 80% you.
Obviously, we don't come totherapy every single day.
Most patients come twice a weekor once a week.
Depends on, what their insurancewill pay for what they can
manage into their schedule.
I mean, some people's got kidsor they have grandkids, or they
have obligations that they'redoing.
(18:06):
So I tell them, Look, I'm gonnaempower you to be able to take
care of yourself, but this is aninvestment that you're making in
you.
And all the things that we'retalking about today, the bottom
line is that people need toinvest in their own health.
I can give you all the exercisesto do.
If you don't go home and dothem, you're not going to get
better.
You're not gonna feel better.
Your pain won't improve.
(18:27):
So ultimately, I'm just here tobe the coach or the cheerleader
and say, Hey, the things thatwill make you feel better, but
you gotta go home and do it.
David Lowry (18:35):
Do you find that people are good about following
through on those exercises or isthis a point of contention with
the kind of work you do?
Erin Osmus (18:42):
I would say I'm a pretty good salesperson and most
people weed themselves out.
So most of my patients arepretty compliant or they don't
come back.
Most people will come in and Igive them my sales pitch and
like, Hey, this is what I can dofor you and this is what you can
do for yourself.
And they either buy in or theydon't.
I would say 80% of my patientsthat I see on a regular basis
are compliant because they don'tcome back if they don't.
(19:04):
People are doing it.
People are showing up.
I mean, we're a busy clinic.
David Lowry (19:07):
I'm assuming, and correct me if I'm wrong, but at
the second half of life it'sgoing to be knees, shoulders,
hips and backs.
What's gonna happen to us whenwe walk through the door?
Erin Osmus (19:18):
You'll be greeted with a smile, of course.
And I'm gonna say, Hey, tell meabout your pain.
And I always wanna say, what isthis interfering with in your
life?
But most of the time it'sinterfering with, well, I can't
get on my knees to weed myplants anymore.
Or I can't, get up the bleachersto go see my grandson play
baseball anymore.
So I'm like, okay, well why isthat happening?
Tell me about your pain.
Why is that hard for you?
(19:39):
So I'm gonna assess what's goingon.
When I do it, my back hurts.
Or when I sit on this, I haveall this pain.
Okay?
So we have all kinds of specialtests and things that we're
gonna do.
We're gonna test your strength,test your mobility, and then I'm
gonna give you some exercises toaddress it.
A lot of times it's becausepeople don't move.
Nine times outta 10, they needsome mobility or some
flexibility, or their hamstringsare super tight.
(20:01):
It's movement.
In a very sedentary world I justhave to get people moving most
of the time.
So I give them a home exerciseprogram.
Usually I print it out and givethem pictures.
I'm like, Hey, this is what youneed to do.
And then we make an appointmentto come back and I'm like, Go
home and do these, make mentalnotes, and come back and see me,
make our next appointment andlet's go over it again, and
we'll build on it.
Don Drew (20:20):
After therapy is through, life continues.
What can we do post therapy tokeep on improving, building
strength, building flexibility,mobility, those kinds of things?
Erin Osmus (20:32):
I tell my patients all the time, they're like, Am I
gonna do this forever?
And my answer's yes.
Yes, in some form you're goingto have to do it forever.
That's what I encourage people,depending on what their
lifestyle is, continuing to doit.
And if you get to that pointwhere you're like, Okay, maybe I
want something else.
You can come back and seetherapy again and go, I wanna
advance this program.
Like, I feel really great and Iwould like to do something more.
(20:53):
Or you can see a trainer and agym.
A lot of times we willtransition patients from our
clinic into a gym.
It's called a bridge program sothey're working out themselves.
They've already set theprecedence, they're already
coming to see us twice a week.
I'm like, What's the differenceif you start going to the gym,
you're already coming up here,you're already committed to
this.
So start going to the gym threetimes a week or whatever.
(21:14):
It has to evolve.
And I do try to do that and say,Okay, so if your life is this,
and so now I wanna playpickleball, I wanna do these
things, then you gotta keepstaying active.
So exercise is always somethingyou need to do.
But yes, you wanna progress itand continue to do it.
There's lots of resources outthere.
There's Pilates classes.
A lot of my spine patients, Iwill transition them into some
(21:35):
sort of Pilates class that theycan start doing.
Sometimes patients will start awalking program in addition to
their exercises.
A lot of times I try to givethem like, Okay, if you're on
the, green band, when you leavehere, I'm gonna give you a blue
band.
After, three or four months youneed to start using this band
and then go to the black band tocontinue to do this exercise
because you, you wanna continueto progress for sure.
David Lowry (21:55):
How many times a week do we need to be doing
certain things and give us asample program that an ordinary
person in reasonably good healthcould do?
Erin Osmus (22:03):
First you probably need to make sure that you're
cleared for exercise.
So if you don't see yourphysician on a regular basis,
you need to make sure that yourcardiovascular health is such
that you can exercise.
Make sure your blood pressure iswhere it needs to be, your blood
sugars are managed, if you'rediabetic.
All the things that you need tomake sure that, hey, to your
doctor.
Am I clear to exercise?
He or she says, Yes, you're goodto go.
(22:24):
Then it's reasonable to say,Okay, I need to start with 10
minutes of physical exercise aday, start with that.
And then I wanna move up in twominute increments so that I'm
getting 20 to 30 minutesphysical activity, whether it's
walking, taking a resistanceband and doing some bicep curls,
some overhead reachingstretches.
Exercise comes in all forms.
It's not just the gym.
(22:44):
It's not CrossFit.
It's not necessarily RichardSimmons or whatever.
It doesn't have to be yoga.
It can be a resistance band.
It can be walking yourneighborhood with your wife.
It can be taking your dog for awalk.
It can be taking the stairsversus the elevator.
My big one is are you coffeedrinker?
Yes.
Okay While you're waiting forthat five minutes for that
coffee to perk.
There's not any reason youcan't, raise your heels, go up
on your toes.
Can you stand while you'remaking coffee?
(23:06):
Can you do 10 mini squats whileyou're waiting for that, Keurig
to run through?
David Lowry (23:11):
There's a lot of ways we could do that.
You could do that while you'rewatching television.
Erin Osmus (23:15):
You can watch Jeopardy and raise your arms up,
kick your legs out.
You can do leg kick outs sittingin your chair.
You can pump your ankles.
You can go heel toe.
I tell patients when you're on aplane, I'm sitting there
constantly pumping my ankles,constantly marching in place,
moving my feet around.
David Lowry (23:31):
I love it.
It's easier than you think, andthat's the main thing.
It doesn't have to be somethingyou dread.
It's something that you buildinto your day and easily enough
done.
Don Drew (23:40):
Erin, we've covered a lot of territory today.
What do you think are the mostimportant takeaways from today's
discussion?
Erin Osmus (23:47):
The most important thing is that your physical
health is your responsibility.
You need to take control of yourlife and advocate for yourself.
I hope that somebody thatlistens to this at least takes
away from this to ask theirphysician, What can I do?
Can I have physical therapy?
Am I a candidate for that?
It is your benefit.
If you're in the second half ofyour life and you're under
Medicare, that is your benefit.
(24:08):
You've paid into that.
Utilize your physical therapy ifyou can.
Advocate for yourself with yourphysicians.
Physical therapy is not theirgo-to.
Advocate for yourself.
Ask questions.
What's out there for me?
What can I do?
Pain is not a have to.
I tell patients, I can't promiseyou that I can take away your
pain, but I can give you thingsto rescue yourself from your
pain.
It's not a given.
(24:29):
Okay, well, I'm in my seventiesnow, I'm gonna hurt.
You don't have to, you don'thave to suffer.
There's so much out there and somany things that you can do for
yourself.
And exercise isn't always aboutquantity.
It isn't about, committing anhour a day.
It's about the quality of it,and what you do and what you
commit for yourself.
This is your life.
You gotta live it.
It's so important to take careof your body.
(24:49):
You only, you get one shot atthis.
Don Drew (24:51):
None of us really ever want to have surgery, but
sometimes it's necessary.
And of course, sometimes thereis little we can do to prepare
due to the nature or timing ofthe surgery.
But when we can, therapists likeErin are there to help us
prepare and recover in the bestand fastest way possible.
Erin Osmus, thank you for yourpassion and expertise in
physical therapy and helping somany people prepare and recover
(25:12):
from damage to their bodies andwellbeing.
And thank you for being onPeaceful Life Radio.
Erin Osmus (25:17):
Thanks for having me, David.
Thanks for having me, Don.
Appreciate it.
So I always tell my patients, motion is the lotion.
(00:02):
Start moving.
Exercise comes in all forms.
It's not just the gym.
It's not CrossFit.
It's not necessarily RichardSimmons or whatever.
It doesn't have to be yoga.
It can be a resistance band.
It can be walking yourneighborhood with your wife.
It can be taking your dog for awalk.
It can be taking the stairsversus the elevator.
While you're waiting for thatfive minutes for that coffee to
perk, there's not any reason youcan't, raise your heels, go up
(00:23):
on your toes.
Can you stand while you'remaking coffee?
Can you do 10 mini squats whileyou're waiting for that, Keurig
to run through?
David Lowry (00:31):
Welcome to Peaceful Life Radio.
That was physical therapist ErinOsmus, this is David Lowry, and
with me today is my good friendDon Drew.
Don, how are you?
Don Drew (00:40):
I'm doing great.
David
David Lowry (00:41):
Don.
I wanna hear more about Erin,tell us about her.
Don Drew (00:45):
Absolutely.
Our guest today is Erin Osmus,who holds a Doctorate in
Physical Therapy from BostonUniversity and is currently an
active physical therapist in theMercy Hospital system, and she
has 27 years of experience.
Erin focuses on jointreplacement, stroke rehab, and
head injury rehab.
She practices what she preachesmaintaining a healthy lifestyle
(01:05):
and daily exercise routine.
I first got to know Erin lastyear when I visited her after
tearing the rotator cuff in myright shoulder.
She helped me rebuild thestrength in my shoulder before
surgery so that postsurgicalrecovery went really well and
very quick.
Today Erin is going to talk tous about how we can better
prepare ourselves for impendingsurgeries and work with a
(01:27):
therapist to recover as quicklyand effectively as possible.
Erin Osmus, welcome to PeacefulLife Radio.
Erin Osmus (01:34):
I'm glad to be here, guys.
David Lowry (01:35):
Erin, first of all, I think you did a great job on
Don's shoulder, but I waswondering if you could take care
of that big hump in his back?
Erin Osmus (01:44):
Well, don't think I can do that.
Don Drew (01:47):
I'm gonna get you for that, David.
I'm gonna get you for that oneErin.
I wanna start off with askingyou about general fitness and
the importance of exercise inthe second half of our lives.
Erin Osmus (01:57):
Exercising the second half of your life is
super important.
We need to start with resistancetraining.
As you all know, the older weget, we're prone to
osteoporosis.
We need to build bones.
The best way to do that, reallyto prevent it, needs to start in
your thirties, but if you wannastave it off, usually by your
fifties, you need to startthinking about anything that's
resistant.
But I'm not talking about, youdon't have to hit the gym.
It doesn't have to be heavy, bigweights and dumbbells.
(02:19):
But as you know, from when youand I worked together,
resistance bands, that's superimportant.
Your cardiovascular health isvery important to fitness in the
second half of your life.
The later stages in our life westart facing neurological
deficits.
We have high risk for falls.
The stronger we are, thestronger our core is, the more
important it is for flexibility.
Obviously you wanna minimizemedications and minimize doctor
(02:42):
stays.
Don Drew (02:43):
What about the positive psychological effects?
Erin Osmus (02:45):
There's huge psychological components in
exercise.
Anytime we exercise, we're gonnarelease endorphins, serotonin
levels in our body, which wemake inside of us, which
synthetically areantidepressants and happy pills,
so to speak.
The more you exercise, you canrelease all of that.
I'm a big proponent.
I exercise every day.
Have you ever heard the wordrehab junkie?
(03:06):
The more you exercise your bodystarts producing these
endorphin, starts producingthese serotonin levels and we
start to crave it.
I can't go to sleep.
I can't rest if I haven't workedout.
Like, I just don't sleep good.
I miss it and people crave it.
So psychologically, the more youwork out, the happier you are.
David Lowry (03:21):
Erin, it sounds to me like if we had to put it into
categories you're going to needsome strength, physical
strength, so we do someresistance training.
You need cardiovascular health.
And then flexibility is a goodidea, right?
Erin Osmus (03:36):
Absolutely.
David Lowry (03:36):
And then all of that together has a synergistic
effect on not only your body,but also your mental health.
Erin Osmus (03:44):
Absolutely.
Let's think about the moreactive we are, the more that you
can do, the better off you areof physiological.
If you physically can't climbthe stairs, there's, it's a
devastating effect of that.
If you can't walk a householdambulation, you can't go places,
you can't do things.
Your world becomes smaller.
The more fit you are, the moreactive you are.
And you don't have to runmarathons, but you wanna be in
good enough shape to be able toenjoy dinner, go to church and
(04:05):
park in the back of the parkinglot if you can't find a close
space.
You wanna be able to go to thetheater.
You wanna be able to do thingsthat your body can physically
tackle without being a burden toyou, your family, or whatever.
Don Drew (04:15):
One of our goals today is to focus on pre-surgical
preparation and how to rehabourselves after surgery.
Let me just ask you, in terms ofpre-surgery, if we know that
we've got a surgical procedurecoming up, in which we're going
to be needing some kind ofrehabilitation, what are the
most important things a personcan do physically to prepare
(04:37):
their body for that surgery?
Erin Osmus (04:38):
Obviously it depends on, if it's a joint replacement
or kind of surgery you'rehaving, but the better shape
you're in going into any kind ofsurgery, obviously the better
off you are.
So I made myself some noteshere.
A lot of times people will havetherapy, kind of a last ditch
effort to prevent surgery.
They'll go to physical therapy,have therapeutic interventions,
which will then decrease therisk of having to have the
(05:00):
surgery.
Well, the stronger you are goinginto that, obviously the better
off you're gonna be.
I tell people the thing thatthey really need to think about
is that you need to beproactive.
At Mercy, we're starting to getthis trickle down effect with
physicians to send people to PTas a protocol prior to surgery,
we call prehab, so that they cango and meet with a therapist,
kind of figure out what's gonnabe their plan.
(05:22):
Are they gonna go into surgeryand then go to home health?
Are they gonna go to outpatient?
What is their home situationgonna look like?
What are they gonna need?
A lot of times you, yourselfwill know you come outta surgery
and there's not a lot you can doin the very beginning, but there
are some isometric exercises youcan do, some things that would
help you immediatelypostoperatively before you get
to the therapy sessions.
(05:42):
And we would like to be able tohave that kind of intervention
with people right off the bat.
So my supervisor and I areeducating physicians and getting
them to let us get our hands onpatients before they even get
into surgery.
Think about it.
If you can meet your therapistprior to that surgery, when you
come out, you know what toexpect.
Psychologically you are gonna bea lot less nervous.
You're gonna be a lot lessapprehensive.
You are gonna know what toexpect.
(06:03):
You can picture what this isgonna be going into that.
Don Drew (06:05):
I'm glad you brought that up because I remember in my
case what happens when I visitedmy physician and he thought I
would need surgery, but I wasn'table to have it for a
significant period of timebecause I already had a couple
of big hikes.
And these are like internationaltrips already planned.
So I needed to follow throughwith those first.
So I had a twofold goal.
One was to get myself ready tohandle the hikes, and then
(06:31):
following that to prep forsurgery because I pushed surgery
out so far.
Erin Osmus (06:35):
And like I tell a lot of patients, I'm not gonna
fix your rotator cuff.
Obviously that's torn.
But what we can do is we canstrengthen all the muscles
surrounding it.
Joints above and below.
So if it's your knee, we wannamake sure your hips and your
ankle are super strong.
If it's your shoulder, we wannamake sure you've got good
cervical range of motion.
Wanna make sure your elbow andyour hands are in good shape.
And we can have you going intothat so all the surrounding
(06:55):
tissue and the surroundingmuscle are in the best shape
that it can be before you gohave that surgery.
We can do a lot of strengtheningprior to going in so that you're
prepared.
I've had several patients,they're like, Hey, I've got this
big trip to Europe planned.
Like I don't wanna have thisknee surgery until, I have more
vacation in the winter.
Let's get those quad muscles asstrong as possible.
Let's get your cardiovascularshape in so that you can
(07:16):
tolerate and do a lot morethings.
If you're not fantastic shapeand barely making it to the
mailbox, what's it gonna be likepostoperatively if you're on
crutches?
So being in the best shape thatyou can prior to that is only
gonna help you.
David Lowry (07:27):
So this prehabilitation you're talking
about, is this mostly forjoints, or for other conditions
as well?
Erin Osmus (07:35):
Well, it's funny that you say that.
I, myself just had surgery thispast spring and I'm very fit.
I work out every day.
It was kind of an unexpectedthing, but I knew I was going
into it probably two monthsbefore, and I just asked my
doctor, Is it safe?
Can I continue to work out?
She was like, absolutely.
Literally the day before I hadsurgery, I did a 10 mile ride on
my Peloton and had surgery thenext day.
(07:55):
I could barely walk to thenurse's desk, which I laughed
about and I thought, this isreally tough and look how good a
shape I'm in.
I don't know if I'd have evenbeen able to get out of bed if I
hadn't been working out prior tothat.
In my recovery, they tell me,Oh, it'll probably take you six
months before you're back.
Hundred percent.
Well, I'm about three months outand I feel great.
David Lowry (08:12):
Wow.
Way to go.
That's an important thing.
I never heard aboutPrehabilitation.
So Don, this is a really goodthing to learn about on our
program because I suspect quitea few people in the second half
of life are going to need thatkind of information.
Don Drew (08:25):
I had a question for Erin about how far in advance of
surgery someone should beginworking with a physical
therapist.
But I was also reminded that notall insurance will cover people.
So I think part of my questionis not just how far in advance
to surgery, should someone beginworking with a physical
therapist, but if they can't,what are some strategies perhaps
(08:46):
they can do on their own?
Erin Osmus (08:48):
A lot of times you can ask your physician.
There are some doctors that arepretty good that have some
handouts.
They have some worksheets.
That's the thing that mysupervisor and I are doing some
research so that we can posethis to insurance companies
because not everybody canphysically get to therapy.
Not everybody has the financialmeans or insurance to cover it.
But talk to the physician.
Say, Hey, what do I haveavailable to me?
(09:09):
What's safe for me to do?
A walking program is a goodplace to start.
A lot of my patients they'relike, I can't walk that far?
Can you walk to the mailbox?
Start with that.
Can you walk to the end of theblock?
Start with that.
If you're safe to do so, ifweight bearing is tough for you,
then try an exercise bike.
I like recumbent bikes for thesecond half of our life.
I'm a big proponent of those.
I like good back support.
It's non-weight, it's closedchain, so you don't have the
(09:31):
impact of walking or running.
A lot of local gyms, a lot ofMedicare and several different
supplements will pay for silversneakers.
A lot of times you can go into agym and say, Hey, are there any
options with my insurancecompany that some of this will
be funded?
You can get a trainer you canwork with, and some of that's
paid for.
We just have to be proactive.
It's your health.
You gotta ask questions.
(09:52):
And I take for granted theknowledge I have.
My mom and my brother are boththerapists, but we were talking
one day years ago about how theknowledge we have, we feel like
is such common sense.
We're like, everybody shouldknow this.
But everybody doesn't know this.
And a lot of times physiciansoverlook and assume that people
know.
So you have to ask, Hey, what'sout there for me?
What's available?
Can I go to therapy?
Can I try that before surgery?
(10:13):
Is that an option for me?
David Lowry (10:14):
While we're talking about being proactive, I'm one
of those people who don't knowvery much about physical
therapy.
Do you have to have a doctorrecommend you?
How does one get into physicaltherapy in the first place?
Erin Osmus (10:26):
You need a physician's order to get into
physical therapy.
You need to check with yourinsurance.
Obviously, there's cash pay.
You can pay if you have themeans if your insurance doesn't
cover it.
But most people, your insurancewill cover physical therapy.
You need a physician's order.
Any doctor can write it.
A PA, a Nurse Practitioner, itdoesn't have to be an ortho, it
doesn't have to be some bigspecialist.
Most general practitioners willwrite you an order for physical
therapy.
You just have that referral sentto whatever clinic is close to
(10:48):
you that does what you need themto do.
And they'll call and set up yourappointment.
I do tell patients don't fallthrough the cracks.
If you're supposed to havephysical therapy and nobody
calls you.
Follow up.
You gotta take control of yourown health.
David Lowry (11:00):
That's the truth.
Let's ask a question aboutexercises that you think we
probably ought to all be doingto help us in the second half of
life to maintain this goodphysical health that you're
talking about.
Erin Osmus (11:11):
I believe people hear the word exercise and they
think, Oh, it's a CrossFit Gym,or it's, oh, it's Richard
Simmons.
Or, oh, I have to be in thisformal setting.
It absolutely doesn't.
There is so much out there.
We have so much information.
I'm a big proponent of Pilates.
I like it.
It's a lot of core strengtheningfor people.
It's resistance training.
You don't need a lot ofequipment.
(11:32):
You can Google Pilates and itcomes up with lots of different
things.
It's wonderful for spines.
People have a lot of back painand a lot of back problems.
It's a lot of corestrengthening.
Strengthening your core is agreat place to start.
People, if they have bad knees,they can't walk.
Like I said before, I lovecycling.
I think a recumbent bike isgreat.
If you don't have a lot ofequipment, you can do a complete
(11:54):
workout with a resistance bandyou can buy at Target or Walmart
or Dick's.
If you come to physical therapy,we'll give you one for free.
Resistance is super important.
I'd like to see that because itbuilds better bone health versus
an open chain workout, like abicep curl or such.
If you don't have weights, youcan use a water bottle.
It's, 16 ounces.
All the time tell my patients,start with a can of soup.
(12:15):
Start doing some bicep curlswith a can of soup.
You can get some resistance.
It doesn't have to be rocketscience.
Don Drew (12:20):
You mentioned pain, Erin, I wanna ask if it's
possible that physical therapycan help reduce the need for
pain medication after surgery?
Erin Osmus (12:28):
Pain management is a huge part of physical therapy.
We have modalities, you haveheat, you have ice, we have
movement, manual therapy.
Pain management is huge.
And obviously you come outtasurgery, lots of people on
narcotics, postoperatively, butthe less time you're on pain
meds, the better for your wholebody in general.
You get lots of secondaryissues.
So I always tell my patients,and you've heard this before,
(12:49):
motion is the lotion.
Start moving.
You're gonna start feelingbetter.
A lot of times we have poorposture.
Even with our joint replacementsI do a posture alignment on
everybody.
The first thing I do is, let'slook at your posture.
And they're like, Well, I'm herefor my shoulder.
Yeah, but let's talk about that.
If your shoulders all rolledforward because you've been a
desk job your whole life let'sget yourself in better posture.
David Lowry (13:07):
A question I have, Erin has to do with walking
versus running.
Can you clarify the role ofwalking and running as a form of
exercise for seniors?
Erin Osmus (13:17):
Sure.
To each their own.
Running is gonna be hard on yourjoints because it's gonna be
high impact.
So every time your foot hitsthat concrete, think about all
the force that goes up throughthat ankle, up through that
knee, up, through that hip, upthrough that spine and every
vertebrae of your spine.
But lots of people run well intothe later stages of their life.
Walking and running.
Either one.
You wanna get your heartelevated.
You wanna get your target heartrate.
(13:38):
You can Google target heartrate.
It's like two 20 minus your age.
It's all at an individual basis.
If you're trying to lose weight,walking actually is gonna
probably burn more calories.
I tell patients that and theynever believe me.
Oh, I should be running.
Not necessarily.
You wanna get 20 minutes ofwalking or 20 minutes of running
to hit a good aerobic, to getgood cardiovascular effects.
You gotta start somewhere.
(13:58):
Not everybody can go out andwalk 20 minutes or run 20
minutes.
I always tell patients, Startwith what you can do.
Start with five minutes andincrease, two minute intervals
at a time to be safe.
David Lowry (14:07):
I'm one of the fortunate ones who has a wife
that loves to get up every dayand we walk and solve the
world's problems for 45 minutesevery day.
Erin Osmus (14:15):
I love that.
That is fantastic.
And walking, I can tell patientsif you do nothing but walk, it's
so good for you.
You get your arms pumping, getmoving.
Don Drew (14:23):
Let's turn our attention now to post-surgery.
Right?
We, so we've gotten ready forthe surgery.
We've done what we can tostrengthen ourselves, say it's a
joint, and we've done what wecan to strengthen the muscles
around there and our enduranceand we're feeling pretty good
about where we're at going intosurgery.
We're now out of surgery, and,of course, we're hurting.
At first we're on some prettyserious drugs usually.
(14:45):
And you wanna, try and tailoryourself off that as quickly as
possible.
But nonetheless, you wanna bestarting your physical therapy
within, I don't know, what is itabout, anywhere from a few weeks
to a few months.
The hospital's gonna want you tomove right away.
Erin Osmus (14:59):
When I worked inpatient, I got knees and hips
up day one.
They came out of surgery thatmorning, I was walking them that
afternoon.
Don Drew (15:05):
What is the typical or average situation look like for
somebody coming out of surgery?
They're out a couple weeks to amonth.
They're gonna see a physicaltherapist for the first time.
What's gonna happen?
Erin Osmus (15:16):
Usually when a patient comes home, depending on
the level of assistance and howmuch support they have at home,
a lot of these surgeries used tobe, you would stay in the
hospital for sometimes a week.
Now these are outpatientsurgery, so you're going home
immediately.
A lot of patients are gonna gethome health.
They're gonna have a home healththerapist come into the house.
If you're up and going and yourdoctor says you're ready for
therapy to get into anoutpatient setting, but some
(15:38):
patients have home health and atherapist will come into their
home and do some therapy.
It's minimal.
They're just kind of gettingthem moving.
Usually by week two, dependingon the joint or whatever,
they're coming into theiroutpatient setting.
They've made an appointment.
There's usually a little bit ofpre paperwork to come in.
They're gonna meet thattherapist and then get an
evaluation.
An evaluation's gonna consist ofmeasuring.
If it's the knee, we're gonnasee how much can you actually
(16:00):
move it?
How much can I actually move it?
How much pain are you gonna bein?
They're gonna ask you to rateyour pain zero to 10, zero being
no pain, 10 being I need to goto the emergency room.
They're usually gonna give you ahome exercise program.
Move it around a little bit andthen we're gonna talk about your
pain management.
Are you using ice?
Are you icing it rightreligiously at home?
That's a naturalanti-inflammatory.
(16:22):
Let's make sure we're doing it.
You, you've got lots of edema.
Those are the kinds of things wewanna get you out of.
Then we're gonna set upappointments.
And each time it's gonna build.
So depending on the protocol,the physician, so obviously as a
physical therapist, I work underphysician's orders.
So they're gonna have a protocolfor their expectation of
movement.
With each stage we're gonna moveyou a little bit more.
We're gonna assess your pain.
The general rule of thumb isthat the more you're moving, the
(16:44):
less pain you're gonna be in.
Don Drew (16:45):
What I hear you saying is that as a therapist you are
going to be an evaluating eachpatient individually and
designing a rehab program basedupon how well they're doing,
what their pain levels are andso forth.
So everybody's gonna be treateda little bit different.
There's not necessarily a singleprotocol for all people who have
had shoulder surgery?
Erin Osmus (17:03):
No, the movement is the same, but what they wanna do
is completely different.
I mean, I have a patient that,he's a truck driver.
He has to be able to get up andinto that truck.
So guess what we're doing?
We're working on steps.
We're working on how he can pullhimself up.
We're gonna work on compensatorystrategies if he's right-handed,
and really needs to be able touse that right hand.
Okay.
We're gonna have to startstrengthening this left hand a
little bit.
Every patient's different.
If this patient's like, Oh, hey,I take care of my elderly
(17:25):
husband.
I need to be able to get homeand be able to do this for him.
Every single person isdifferent.
And it doesn't matter what mygoals are for you, what matters,
what your goals are.
So you want your physicaltherapist to ask you, What are
your goals?
That's the most important thing.
What do you wanna accomplish outof this?
I need a buy-in.
I'm selling this to you.
You're walking in that door andI have all these things that I
need you to be able toaccomplish.
(17:45):
But if you don't believe in whatI'm telling you, and you don't
believe that it's gonna work,you're not gonna do it.
Basically with physical therapy,it's 20% that therapist, and
it's 80% you.
Obviously, we don't come totherapy every single day.
Most patients come twice a weekor once a week.
Depends on, what their insurancewill pay for what they can
manage into their schedule.
I mean, some people's got kidsor they have grandkids, or they
have obligations that they'redoing.
(18:06):
So I tell them, Look, I'm gonnaempower you to be able to take
care of yourself, but this is aninvestment that you're making in
you.
And all the things that we'retalking about today, the bottom
line is that people need toinvest in their own health.
I can give you all the exercisesto do.
If you don't go home and dothem, you're not going to get
better.
You're not gonna feel better.
Your pain won't improve.
(18:27):
So ultimately, I'm just here tobe the coach or the cheerleader
and say, Hey, the things thatwill make you feel better, but
you gotta go home and do it.
David Lowry (18:35):
Do you find that people are good about following
through on those exercises or isthis a point of contention with
the kind of work you do?
Erin Osmus (18:42):
I would say I'm a pretty good salesperson and most
people weed themselves out.
So most of my patients arepretty compliant or they don't
come back.
Most people will come in and Igive them my sales pitch and
like, Hey, this is what I can dofor you and this is what you can
do for yourself.
And they either buy in or theydon't.
I would say 80% of my patientsthat I see on a regular basis
are compliant because they don'tcome back if they don't.
(19:04):
People are doing it.
People are showing up.
I mean, we're a busy clinic.
David Lowry (19:07):
I'm assuming, and correct me if I'm wrong, but at
the second half of life it'sgoing to be knees, shoulders,
hips and backs.
What's gonna happen to us whenwe walk through the door?
Erin Osmus (19:18):
You'll be greeted with a smile, of course.
And I'm gonna say, Hey, tell meabout your pain.
And I always wanna say, what isthis interfering with in your
life?
But most of the time it'sinterfering with, well, I can't
get on my knees to weed myplants anymore.
Or I can't, get up the bleachersto go see my grandson play
baseball anymore.
So I'm like, okay, well why isthat happening?
Tell me about your pain.
Why is that hard for you?
(19:39):
So I'm gonna assess what's goingon.
When I do it, my back hurts.
Or when I sit on this, I haveall this pain.
Okay?
So we have all kinds of specialtests and things that we're
gonna do.
We're gonna test your strength,test your mobility, and then I'm
gonna give you some exercises toaddress it.
A lot of times it's becausepeople don't move.
Nine times outta 10, they needsome mobility or some
flexibility, or their hamstringsare super tight.
(20:01):
It's movement.
In a very sedentary world I justhave to get people moving most
of the time.
So I give them a home exerciseprogram.
Usually I print it out and givethem pictures.
I'm like, Hey, this is what youneed to do.
And then we make an appointmentto come back and I'm like, Go
home and do these, make mentalnotes, and come back and see me,
make our next appointment andlet's go over it again, and
we'll build on it.
Don Drew (20:20):
After therapy is through, life continues.
What can we do post therapy tokeep on improving, building
strength, building flexibility,mobility, those kinds of things?
Erin Osmus (20:32):
I tell my patients all the time, they're like, Am I
gonna do this forever?
And my answer's yes.
Yes, in some form you're goingto have to do it forever.
That's what I encourage people,depending on what their
lifestyle is, continuing to doit.
And if you get to that pointwhere you're like, Okay, maybe I
want something else.
You can come back and seetherapy again and go, I wanna
advance this program.
Like, I feel really great and Iwould like to do something more.
(20:53):
Or you can see a trainer and agym.
A lot of times we willtransition patients from our
clinic into a gym.
It's called a bridge program sothey're working out themselves.
They've already set theprecedence, they're already
coming to see us twice a week.
I'm like, What's the differenceif you start going to the gym,
you're already coming up here,you're already committed to
this.
So start going to the gym threetimes a week or whatever.
(21:14):
It has to evolve.
And I do try to do that and say,Okay, so if your life is this,
and so now I wanna playpickleball, I wanna do these
things, then you gotta keepstaying active.
So exercise is always somethingyou need to do.
But yes, you wanna progress itand continue to do it.
There's lots of resources outthere.
There's Pilates classes.
A lot of my spine patients, Iwill transition them into some
(21:35):
sort of Pilates class that theycan start doing.
Sometimes patients will start awalking program in addition to
their exercises.
A lot of times I try to givethem like, Okay, if you're on
the, green band, when you leavehere, I'm gonna give you a blue
band.
After, three or four months youneed to start using this band
and then go to the black band tocontinue to do this exercise
because you, you wanna continueto progress for sure.
David Lowry (21:55):
How many times a week do we need to be doing
certain things and give us asample program that an ordinary
person in reasonably good healthcould do?
Erin Osmus (22:03):
First you probably need to make sure that you're
cleared for exercise.
So if you don't see yourphysician on a regular basis,
you need to make sure that yourcardiovascular health is such
that you can exercise.
Make sure your blood pressure iswhere it needs to be, your blood
sugars are managed, if you'rediabetic.
All the things that you need tomake sure that, hey, to your
doctor.
Am I clear to exercise?
He or she says, Yes, you're goodto go.
(22:24):
Then it's reasonable to say,Okay, I need to start with 10
minutes of physical exercise aday, start with that.
And then I wanna move up in twominute increments so that I'm
getting 20 to 30 minutesphysical activity, whether it's
walking, taking a resistanceband and doing some bicep curls,
some overhead reachingstretches.
Exercise comes in all forms.
It's not just the gym.
(22:44):
It's not CrossFit.
It's not necessarily RichardSimmons or whatever.
It doesn't have to be yoga.
It can be a resistance band.
It can be walking yourneighborhood with your wife.
It can be taking your dog for awalk.
It can be taking the stairsversus the elevator.
My big one is are you coffeedrinker?
Yes.
Okay While you're waiting forthat five minutes for that
coffee to perk.
There's not any reason youcan't, raise your heels, go up
on your toes.
Can you stand while you'remaking coffee?
(23:06):
Can you do 10 mini squats whileyou're waiting for that, Keurig
to run through?
David Lowry (23:11):
There's a lot of ways we could do that.
You could do that while you'rewatching television.
Erin Osmus (23:15):
You can watch Jeopardy and raise your arms up,
kick your legs out.
You can do leg kick outs sittingin your chair.
You can pump your ankles.
You can go heel toe.
I tell patients when you're on aplane, I'm sitting there
constantly pumping my ankles,constantly marching in place,
moving my feet around.
David Lowry (23:31):
I love it.
It's easier than you think, andthat's the main thing.
It doesn't have to be somethingyou dread.
It's something that you buildinto your day and easily enough
done.
Don Drew (23:40):
Erin, we've covered a lot of territory today.
What do you think are the mostimportant takeaways from today's
discussion?
Erin Osmus (23:47):
The most important thing is that your physical
health is your responsibility.
You need to take control of yourlife and advocate for yourself.
I hope that somebody thatlistens to this at least takes
away from this to ask theirphysician, What can I do?
Can I have physical therapy?
Am I a candidate for that?
It is your benefit.
If you're in the second half ofyour life and you're under
Medicare, that is your benefit.
(24:08):
You've paid into that.
Utilize your physical therapy ifyou can.
Advocate for yourself with yourphysicians.
Physical therapy is not theirgo-to.
Advocate for yourself.
Ask questions.
What's out there for me?
What can I do?
Pain is not a have to.
I tell patients, I can't promiseyou that I can take away your
pain, but I can give you thingsto rescue yourself from your
pain.
It's not a given.
(24:29):
Okay, well, I'm in my seventiesnow, I'm gonna hurt.
You don't have to, you don'thave to suffer.
There's so much out there and somany things that you can do for
yourself.
And exercise isn't always aboutquantity.
It isn't about, committing anhour a day.
It's about the quality of it,and what you do and what you
commit for yourself.
This is your life.
You gotta live it.
It's so important to take careof your body.
(24:49):
You only, you get one shot atthis.
Don Drew (24:51):
None of us really ever want to have surgery, but
sometimes it's necessary.
And of course, sometimes thereis little we can do to prepare
due to the nature or timing ofthe surgery.
But when we can, therapists likeErin are there to help us
prepare and recover in the bestand fastest way possible.
Erin Osmus, thank you for yourpassion and expertise in
physical therapy and helping somany people prepare and recover
(25:12):
from damage to their bodies andwellbeing.
And thank you for being onPeaceful Life Radio.
Erin Osmus (25:17):
Thanks for having me, David.
Thanks for having me, Don.
Appreciate it.
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