July 29, 2025 • 49 mins
Have you been told your pain will never get better? That surgery is your only option? That you just need to learn to live with it?
Dr. Clayton Durr, performance physical therapist who has worked with champion athletes across powerlifting, strongman, and CrossFit, joins the Gaslit Truth Podcast to challenge everything you've been told about chronic pain. Sharing eye-opening insights from his practice, Dr. Durr reveals how our own brains can create "anticipatory pain" even after tissues have healed—and how the medical system often fails to address this crucial disconnect.
Through powerful patient stories, Dr. Durr demonstrates how something as simple as validation and proper movement can eliminate pain that multiple doctors dismissed as permanent. He breaks down the problematic profit-driven algorithm most pain patients experience: doctor visit → X-ray → opioids → injections → surgery, noting that 50% of back surgeries show no improvement in outcomes.
The conversation dives deep into dry needling, a game-changing technique often confused with acupuncture, that provides immediate relief by disrupting muscle spasms and giving patients a "therapeutic window" to begin proper healing. Dr. Durr explains why this approach, though highly effective, remains underutilized in a system that financially rewards surgeries and medications over lasting solutions.
Most importantly, this episode offers hope where the traditional medical system often fails to. As Dr. Durr emphasizes, "The pain may not be your fault, but it's your responsibility." By understanding how your body actually heals and finding providers who truly put patients first, you can break free from the narrative that your pain defines your future.
Ready to challenge what you've been told about your chronic pain? Listen now and discover why hope might be the most powerful pain management tool we have.
Are you tired of being gaslit and want to DEEP THROAT some more truth? We want to hear from you! Message us your gaslit stories at thegaslittruthpodcast@gmail.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr Teralyn Sell (00:01):
You have been gaslit into believing that you
need meds, injections andsurgery for your chronic pain.
We are your whistleblowingshrinks, dr Tara Lynn and
therapist Jen, and you arelistening to the Gaslit Truth
Podcast.
Welcome aboard everyone.
Today we have a special guest.
I've been waiting a while forthis one, actually.
We've been trying to sort thisone out for a few months now.
(00:22):
So Dr Clayton Durr.
Clayton Durr is a physicaltherapist, a doctor, a physical
therapist.
That's important to point out.
He is a performance physicaltherapist who specializes in
performance.
He has worked with national andworld champion athletes in
powerlifting, strongman,crossfit and many other sports.
(00:43):
That's really cool.
He also has a focus in chronicpain and patients who have been
dismissed by the medical systemor gaslit and being told they
are fine.
He is the host of the podcastHeal Without Harm, where he
discusses the pitfalls of themedical system and bringing on
guests who are actively buildinga better system.
(01:04):
Welcome to the show, dr Clayton.
Dr Clayton Dir (01:07):
Thank you so much, both of you, for having me
.
I've been following yourcontent for quite some time and
I'm catching myself watchingbeing like hell.
Yeah, yeah, I feel like we havesimilar paths, different genres
maybe.
Dr Teralyn Sell (01:19):
For sure.
I think there are so manydifferent specialties that Jen
and I are running into that arethinking very similarly now, so
it's really cool when they kindof cross and meet together.
So excited to have thisconversation, particularly about
chronic pain, because I don'tthink we've had that before,
have we Jen?
I don't think we've talkedabout chronic pain.
No, it's a new one.
(01:40):
Yes, it's a new one, and I knowthat a lot of our clients have
a lot of chronic pain andthey've been through the ringer
in pain clinics and things likethat.
So I'm really stoked to listento what you have to say about
this, clayton.
Dr Clayton Dir (01:58):
For sure.
No, and I'm excited to learn alittle bit from y'all, because
there's sometimes where patientswill come in and I can tell
that it's almost like a sensoryprocessing disorder of some sort
, or at least that's playinginto it, where the tissue's
doing fine but you're stillfeeling pain and I know I can
help, but I know I'm not goingto be like the root cause fixer
and so trying to find someone toput them in front of, to finish
(02:20):
that out or assist in that careis something that I'm still
actively looking for.
Therapist Jennifer Schmi (02:26):
That's intriguing.
Dr Clayton Dir (02:27):
That is really intriguing, yes, yeah.
Therapist Jennifer Schmitz (02:29):
So the tissues themselves heal and
you can see that.
And yet there is still thisviewpoint that they take of pain
and there is still a subjectivestatement that there's still
pain levels there.
Dr Clayton Dir (02:43):
Have you guys learned about the homunculus of
the brain?
Does that sound familiar?
Therapist Jennifer Schmitz (02:46):
Does not, did you say, monkey?
Dr Clayton Dir (02:49):
Homunculus Very, very similar.
There's a couple of sharedletters in there.
You don't have to validate.
Therapist Jennifer Schmit (02:54):
Thank you, that's cute, oh, I like
you, it's not quite genuineIdiot.
Stop, it All right the.
Dr Clayton Dir (03:01):
All right.
The brain has a map of the body, and if you just type in
homunculus if you can figure outhow to spell it into Google
you'll see that different partsof the brain perceive sensation
from different parts of the body.
The hands and the feet take upa huge amount of surface area in
the brain, because that's wherewe get most of our sensory from
right.
If I drew the letter four onyour back with, like my
fingernail, you may be able torecognize it, but if I drew it
(03:22):
on your hand, you would knowexactly what you're feeling.
And so the brain has its ownperception of the body, and so
sometimes it gets like thislearned, almost like a learned
behavior, Like if you touch myarm it's going to hurt, so
please don't touch it, and thenthat tissue heals.
But you still think if this armgets touched it's going to hurt
, and so we have to work throughthat.
But sometimes I'm not the bestperson for that because I don't
know how to navigate it or Idon't have the same, maybe
(03:44):
information you guys have inyour brain or I don't know how
to unfold it and have thatconversation.
But most of the time I justlean on exercise and
weightlifting and be like, hey,we're just going to work through
this and kind of through thatprocess, you'll get more
comfortable.
Therapist Jennifer Schmitz (04:00):
It reminds me a little bit of how
traumatic memories are stored intrauma storage right, and how
there may not be a threat andthere is nothing there, like in
front of you, and yet we stillperceive there to be, that,
there for us.
Dr Teralyn Sell (04:15):
Wait, I have a lived experience, a recent one,
because my front tooth cap justcame out right and so I had to
go to I know right.
Anyway, I had to, had to go tothe dentist and she was working
on it and it was so sensitiveand she kept saying this is
weird, because most people don'thave this level of sensitivity
whatever.
And I'm thinking well, I do,but the thing is is that she
(04:37):
would get close to it and itfelt like a jolt of lightning
was, and she was like I barelyeven touched your tooth.
It was like this anticipatory,like you know, and I felt it,
like I felt that pain where itreally wasn't even there.
It was like this and I keptsaying to myself this is
anticipatory pain, this isanticipatory pain Like don't do
(04:57):
it, don't do it.
So I feel like this is like asimilar concept in real world,
like you kind of anticipate thatpain happening.
Therapist Jennifer Schmitz (05:08):
It's along the same line Well, you
got to get your monkey checked.
Then, terry, Get your monkeychecked.
This is seriously.
Dr Clayton Dir (05:12):
It's along the same lines on why amputees still
have like phantom pain, becausethe brain still has the map of
that limb, even though it's notthere.
Therapist Jennifer Schmitz (05:20):
Okay , phantom limb pain.
I know that.
I remember that from Psych 101.
Dr Teralyn Sell (05:39):
Okay, phansom, limb pain I know that, I
remember that from Psych 101physical pain when you have
physical pain heightened, youwill have more emotional pain.
When you have emotional painheightened, you will have more
physical pain.
It's like this feedback loopsystem and I feel like some of
that was anticipatory pain orhistoric pain that you expect to
(06:00):
happen again, or the beliefthat it will never be gone so
you have to live with it forever.
So you know the head isconnected to the body.
Essentially is the moral ofthat?
Dr Clayton Dir (06:11):
Well, then you tell that patient like, oh, by
the way, this tissue is fine, Idon't know why you're still in
pain.
And then that's the end of theconversation.
And then it's like, well, whatam I supposed to do with this?
And so I think even there wasone gentleman actually who came
in.
This was within my first sixmonths of getting out of school,
uh, when I felt like I stillhad no idea what I was doing.
(06:31):
He came in with shoulder painand the story.
I saw him in January but hestarted having pain in, I think,
october.
He got the flu shot and he'snot saying that's what caused
the pain, but that's when hestarted noticing it.
At least it created somesoreness.
Never really went away.
He got that, I believe, inOctober.
November came around aboutThanksgiving.
He went to a doctor.
The doctor said oh, I think you.
He went to two doctors, I don'tremember which order he got the
(06:51):
diagnosis in, but one of themsaid I think you tore something
a little bit, but otherwiseyou'll be fine, it'll heal, kind
of thing, somewhat like.
Sent him off, went a couple ofweeks, pain was still there,
slash getting worse.
Went to another doctor and theyjust said oh, you have
tendonitis and kind of like,dismissed him again, not
necessarily rudely, but like,sent him on, was like, oh,
you'll be okay.
It was christmas eve.
(07:11):
His dad passed away and heremembers that between christmas
eve and like new year's day hewas moving a ton of stuff out of
his dad's house and somebodygoes isn't your shoulder hurting
?
Like you're moving these boxeswithout issue.
He's like oh my gosh, I totallyforgot that I was having
shoulder pain.
And within a day, like it waslike 10 times worse than it was.
He came into my office.
He was a classic, like bluecollar type dude.
(07:32):
He he lives on like a smallfarm.
He's got, you know, the sidebeside, side by side uh, almost
monster truck, golf cart lookingthings like.
The dude is like veryphysically active.
He was also a welder.
Well, I saw him for 30 minutes,by the way, which is normally
an hour eval.
This is like very physicallyactive.
He was also a welder.
Well, I saw him for 30 minutes,by the way, which is normally
an hour eval.
This is like a half hour freeconsult to see if we're a good
fit.
And he was telling me the storyand he's like yeah, I'm a welder
and sometimes I'll have to bein really weird positions, like
(07:54):
they'll be on the ladder, leanedover here, arm you know,
finagled through this like smallhole to weld a.
He said I just don't know ifI'm going to be able to keep
doing my job.
It hurts so bad to go to work.
And I kept asking questions andthen I think the thing that
really rested on his heart washe had a four-year-old son.
He's like I want to be hisbaseball coach.
I want to take him through, youknow, like baseball.
(08:21):
He's like, and I'm afraid thatwon't happen now.
He's like my shoulder hurts.
Know what's hurting you?
Because you're passing all mytests Range of motion is good,
strength is good, mobility isgood.
Me palpating on your tissues isgood.
Like I don't know what's goingon right now, but come back
later this week, let's do a fulleval and let's start treating
the shoulder.
Three days later he came in zeropain, like he had no pain left
at all, and I said, okay, let'stry to hurt you.
(08:41):
Essentially I was like let'slike, do this strength test and
like push it hard, let's playcatch with a ball, but let's
make it a four pound ball.
Like let's push these things tothe limits.
Never saw him again after that,never had pain again and I was
like what the heck was this Like?
Like physically did not touchhim, had a conversation with him
, essentially like validatedwhat he was feeling, saying like
I know they say this, but allmy tests are showing this, let's
(09:06):
go push your tissues to thelimit and see what happens.
And that unlocked like you weretalking about the emotional
side of things and theperspective or perception of
pain, anticipation of pain, andthen also getting like
incorrectly validated,potentially from other doctors,
like when you have a, an imagethat shows a tear, you're like,
oh shit, like what do I do now?
Like what am I losing now?
(09:27):
Am I going to lose my job?
Am I going to lose my abilityto play with my kids?
And then that likecatastrophizes and goes from
there, and so that was a reallycool turning point.
Thankfully, within my firstyear of practice, that really
opened my eyes.
Therapist Jennifer Schmitz (09:38):
So okay.
So does this lead, as we jumpright into this then, does this
lead into the the statement thatyou had made to us that surgery
should never, most of the time,be the first option?
Dr Clayton Dir (09:50):
unless it's like if we don't do this in the next
hour, you're going to lose theability to walk, type of stuff,
or like dramatic, you know, caraccidents and stuff.
Yes, the people who, like theydon't really remember when their
shoulder pain came on, or likethe knee just started bothering
them they started running sixmonths ago and about three
months in my, my knee startedbothering me a little bit those
are the people that end upoftentimes showing up in an
(10:11):
ortho office and getting asurgery.
Or they have back pain and youknow, they end up getting a
surgery.
Those are the people that I'mI'm speaking to now.
Where surgery is.
Often it's this classicalgorithm right, I go to the
doctor.
They take an x-ray.
They don't find anything.
They prescribe opioids andmuscle relaxers.
That doesn't work.
They say, okay, let's get yousigned up for an injection.
They get the injection.
I would say it seems like 10 to15% of the people that come
(10:35):
into my office so a biasedsample but that come into my
office and get an injection.
They report wow, this hurts sobad.
I felt tingles down my leg.
Like this made everything worse, like those are the reports
that I get more often than rare,probably just more in the
uncommon category.
But if that doesn't work, thenthey say all right, let's sign
you up for an ortho consult.
And I think the ortho consultshould be like let's investigate
(10:58):
this and see what's going onfrom an orthopedic standpoint.
Unfortunately, it's more of.
Here's what your MRI shows.
When do you want to havesurgery?
Dr Teralyn Sell (11:11):
And it's almost like no in between.
No, they go straight to surgery.
Dr Clayton Dir (11:13):
It's like you're consulting for surgery at that
point, Exactly.
So a lot of times PT is notrecommended.
I think it's becoming morerecommended, thankfully, kind of
, because insurance is actuallysomewhat requiring it.
However, the way it is sold isthe doctor goes.
I mean you can try PT for sixweeks, or you need to try it
first, but then go ahead andsign up and it's just like cool.
Therapist Jennifer Schmi (11:32):
Thanks , bro, Well and you know, I just
went through this with my knee,and it was one of those things
where I woke up and there it isLike I don't have some great
awesome thing.
That happened where I was likecrossfitting and blew my left
knee out when I was, you know,doing some.
That was none of that good shit, right?
So what's interesting, too, isthere's this insurance, and you
(11:54):
talk a lot about insurance too,so we dive right into this why
insurance does not have yourback in this case.
Right, you shared this with us,right, like, you can tell us
more about why you say that?
But even when it comes to PT,there's limitations on it.
Here is the parameters of howlong you get PT, and then that's
it.
And so I often question that,too, where you get your six
(12:16):
sessions of PT and you're done,and then patients are done.
You're just, you're done.
Dr Clayton Dir (12:22):
Yeah, and a lot of times they're no better, um,
or they're just a little better,right, right.
And what's frustrating here'smy thought that like goes into
the conspiracy type of thing.
Dr Teralyn Sell (12:31):
But not even conspiracy, but it's like
realistic at the same time.
Therapist Jennifer Schmitz (12:35):
This is very real.
Dr Clayton Dir (12:35):
It is.
Who makes money from theinsurance or from, like big
pharma, who makes money off ofPT?
Like nobody, like not thephysical therapist, that's right
, of course no.
In the nin like nobody like,not the physical therapist,
that's of course no.
In the 90s they made more money.
In the 1990s, a bachelor'sdegree in physical therapy got
you more money per patient thanin 2025, where I had to do a
seven-year degree and drop over100k yes so because, because
(12:57):
physical therapists now themajority of them are required to
have a correct yeah, well, Ihad the bachelor's and were
grandfathered in, or themaster's Right.
Dr Teralyn Sell (13:07):
So that's kind of a newer-ish.
I mean I'm old, but that's kindof newer and I would say I was
even below normal, like mostpeople.
Dr Clayton Dir (13:12):
I think the average there was I can't
remember the website, but therewas a website that helped PTs
pay off debt.
But they helped everybody, butprimarily 150 to 170 in order of
hundreds of thousands ofdollars of debt for PT.
And then we come out and wemake 60 to 80.
Like my brother graduated fromengineering school at four years
(13:34):
and they're making 80 K twoyears out of school and I'm like
right.
I wish I would just be okay withsitting at a desk all day.
That'd be nice.
Not to dismiss them ordiscredit them, but like that's,
that's a way better.
Dr Teralyn Sell (13:51):
We understand, we, uh, yes, we totally
understand that.
So I want to circle back to thestatement that you said.
Sometimes it's it's the waythat it's sold.
Um, that the intervention, theway that the intervention is
sold is, is very important, andI think about this as you're
talking.
I was like, yeah, PT is kind oflike mental health, kind of
like the red haired stepchild ofthe medical model, if you will
Like, because we're often thelast sold to for, especially for
(14:16):
pain patients.
Well, you could go see atherapist what do you think?
It's all in my head.
And then suddenly that thatpatient doesn't want to see a
therapist.
They don't want that andthey're resisting pretty much
everything because they've beensold this idea and also the way
other interventions arepresented to them as being, well
(14:37):
, you could try it, but right,Kind of like physical therapy.
Dr Clayton Dir (14:42):
Yeah, honestly, I, uh, I I'm a huge analogy and
metaphor type person.
Um, it's the way my brain worksand I think it's the best way I
can relate to people.
And I was just listening toSimon Sinek, uh, a couple of
days ago, and I love the way hetalks on a lot of stuff, and
there was things that he wassaying that resonated a lot with
me, and he talked about how, in2020, everything got blown up.
(15:04):
His business life was goingdown.
He's like yet I had the besttime of my life.
He's like the amount of problemsthat I had to solve and the
challenges that were faced infront of me.
Although it was a lot ofnegative, it was enjoyable and I
liked the flow state that I wasin and all that.
And I think that's how it isfor me.
When it's like the moreproblems that show up from a
high perspective on you know ourtype of conversations, trying
(15:26):
to change public, uh perceptionand stuff like that or even just
when someone comes in and I'vehad somebody sit in front of me
and say how many times do I haveto come here before I get my
mri?
Dr Teralyn Sell (15:35):
oh yes, what do you think that's gonna?
Dr Clayton Dir (15:37):
give you, you know, and what I enjoy about
that, though, is like okay, cool, the difficulty level in
today's case is expert mode.
This person thinks you areworthless and this is not going
to be helpful at all, and I'mlike, just sit back and like I'm
going to sell you on this Now.
Some people are just not goingto be sold, but I enjoy that
challenge now, where it used tointimidate the absolute hell out
of me, where I will use theirown reasoning to like, get them
(15:59):
to be back on my side.
Like, what do you think the MRIis going to give you?
Well, it's going to tell mewhat tissue is wrong.
Okay, so do you believe thattissue is the reason you're in
pain?
Well, sure that you know.
It says my supraspinatus isslightly torn.
Okay, let's test it.
I've got three tests to test andsee if that tendon is
(16:19):
problematic or weak or painful,and then we'll go from there
tell you right now, because youcan lift your arm.
No, I don't think it'scompletely ruptured, and so
you're going to get way betteroutcomes by going through PT and
letting it heal.
Do you want to be in a you know, in a sling for the next eight
weeks?
No, can you do your job likethat?
No, okay, cool, so stick withme, let's save you time.
Money's get to this, you know.
And then we go one step further, and in that session I will
(16:46):
have a test that hurts, or teststhey can't do right, a range of
motion test, a strength test,something like that and then I
will find the tissue that Ithink is wrong and I will dry
needle it.
Are you guys familiar at allwith dry needling?
Dr Teralyn Sell (16:56):
So I've never had dry needling.
I've heard of it.
If you want to explain that alittle bit, I think that would
be an appropriate thing to do,for sure.
Dr Clayton Dir (17:03):
I'll circle back to it right after I finish this
kind of like little storyline.
So I will dry needle thatmuscle and let's say it was
eight out of 10 pain once theygot to like 90 degrees of
lifting their arm.
So they get up and they'repointing to the side and that
hurts eight out of 10 pain.
We dry needle the muscles thatI found to be problem and we
retest and you see their face goup to 90 degrees in that
anticipatory pain that you'retalking about.
And then you see this like ohshit, and they're like who are
(17:27):
you?
I'm a magician.
And they get like 160 degrees,like almost up to their ear, and
they're like this hurts likethree out of 10.
Like what did you do?
And it's like, oh, I got thatmuscle to essentially like calm
down, I changed your painperception and then it got you
to move it.
I you still get surgery nowsignificantly with with that.
(17:56):
So let's get after this, youknow.
And then there, and so that'swhat I've really with initial
eval.
So, going back to the dryneedling, I love how many great
inventions or findings orcomplete accidents.
And so they actually found dryneedling by, they were doing a
study and they're doing triggerpoint injections.
So injections on trigger pointsare like knots in the muscle
(18:17):
and they of course do like Idon't know, double blind or
whatever.
Some people get injected, somedon't.
Well, the people that gotinjected sorry, the people that
got a needle but no injectiongot better.
Because when you put a needleinto a muscle that is in a
trigger point or in spasm, if wewant to think of it this way,
like, imagine like 10 of thesemuscle fibers are stuck in
(18:37):
cramping.
They're just turned on, theycan't turn off.
That's where a lot of your painis coming from and your
dysfunction.
And then we have to figure outwhy.
But that dysfunction is stuck.
If you just poke it with aneedle, it disrupts that spasm.
Usually it is temporary.
You'll get two to five daysrelief from the first session of
dry needling.
But when I put that needle inthere you'll get this twitch and
cramp, like sensation, and thenit'll relax and you get what we
(19:00):
call a therapeutic window,generally in the first sessions,
of about two to five days ofless pain with movement, less
pain when using that muscle,stretching it, strengthening it,
whatever it may be, and that'swhat I tell them.
I said I can dry needle youevery week, give you no other
instructions and I'llpractically be a chiropractor
who pops your back.
You just keep coming back.
I'll keep you know, but if youwant to solve this thing long
term, take advantage of the timethat I just gave you and go do
(19:22):
the exercises I recommend toactually solve the problem in
this muscle and make it not goback into spasm.
That's how you stop seeing me.
Dr Teralyn Sell (19:36):
That's in your life again without pain, and so
it gives them the power.
But I'm helping them shortcut.
I'm just enamored by thisbecause I keep rolling through
my brain on how many peopledismiss PT.
And by the way, I've dismissedPT.
I have.
Dr Clayton Dir (19:48):
Honestly, to give you some credit, I dismiss
a lot of PTs when I'm the thirdone they saw and they're like
why is this so much different?
And I'm like what exerciseswere you doing?
And they hand me a 1980s printoff.
That's been 17 times.
And it's like stretch yourcalves, stretch your quads,
stretch your hamstrings, stretchyour hips, do the pigeon
stretch?
And I'm like, yeah, none ofthose are going to help you.
(20:08):
And they're like they don't.
And I'm like how long does ittake you?
28 minutes, like I would quittoo.
And so.
I'm trying to decide is it the?
Orthos and surgeons giving us abad name, or is it other
physical therapists?
And a lot of the times I wouldsay some, not a lot of times,
but it seems like half the timeit's PTs and corporate medicine,
whether they want to be thereor not, where they have to see
(20:28):
two or three people an hour, andso then they just default to
like, well, let me just show up,hand the piece of paper, tell
them, yeah, it's probably thattissue, and then not actually
solve problems.
Therapist Jennifer Schmitz (20:37):
So it's not individualized is what
you're saying.
Dr Clayton Dir (20:42):
Most people it's not no.
So our clinic is cash-based.
We're out of network and we seefive to eight people a day per
provider and my boss was thesixth person to join a
mastermind and PTs like us, ptsthat run clinics like this.
There's now over 200 people inthat mastermind and they have a
(21:03):
course where they walk peoplethrough a three month process on
how to start a clinic like thisand run it.
They've now helped over athousand clinics throughout the
nation.
So it's coming like things arehappening right and so PTs are
getting out of that like millran PT.
It's coming around and so thenit's like on TikTok.
One of the best ways I've foundto help people is show them what
(21:24):
I do.
Kind of like you guys talkabout what you do and then
they're like hey, can you helpme?
I'm like I'm in Wichita, whereare you?
Boston?
Cool, can't help you.
And I actually went to thisfacebook group of 6 000
providers and I said can youguys please fill in this excel
spreadsheet for me?
And so I will go on there, findsomebody in boston.
I will kind of like verifytheir website and you can
usually tell the differencebetween corporate medicine and
(21:45):
like one of these guys and I'llsay, hey, check out, you know,
move better pt on north fourthavenue, whatever, and they'll be
like great.
And then month later youknow'll see in that Facebook
group, whoever sent me somebodyin Boston, they said they saw
somebody on TikTok.
Thanks for the referral.
That's been my attempt to tryto get people to more PT and
(22:05):
validating that like, yeah, Iwould have quit the PT that you
tried the last three times aswell.
Therapist Jennifer Schmit (22:09):
Which would be the more traditional.
As you say it right, the waythat traditional PT can fail
patients.
This is kind of what you'retalking about.
Dr Clayton Dir (22:17):
Exactly, yeah, they're not helping people, but
it's because insurance stillpays for it.
Insurance still reimburses.
If I put an ice pack onsomebody's back, they'll give me
$12.
Therapist Jennifer Schmitz (22:29):
Who shouldn't do this?
Who can't do dried needling.
Dr Clayton Dir (22:33):
What kinds of patients?
Therapist Jennifer Schmit (22:34):
can't do that, like who can't do
dried needling.
Oh, good question.
Dr Clayton Dir (22:35):
Can't do that.
Yeah, there's not manycontraindications.
Pregnancy if you're going to bedoing any sort of dry needling
around the area, like if you'redry needling their calf and
stuff, you should be fine.
I would say that we still jointhe whole like don't do anything
to this lady in the firsttrimester, cause you never know
what could happen.
But I've, I just straight updon't dry needle anybody who's
pregnant.
And plus we've got now a pelvicfloor specialist who takes on
(22:57):
those gals.
If these people have asuppressed immune system,
autoimmune disorders, thingslike that, we're going to be
very cautious, potentially justnot do it at all.
Needlephobic they're scared ofneedles.
I've got one gal actuallycoming in today that she still
won't let me dry needle her.
Dr Teralyn Sell (23:18):
I'm like I promise you it will make your
hip better, but we don't like.
Dr Clayton Dir (23:20):
I'm like gradual , informed nudging, uh type, but
I don't want to make your ptstworse at the same.
Yeah, exactly.
And then, um, if there's activeinfection in the area, if
they're on like blood thinners,will be a little bit more
cautious.
I mean honestly, like from amedical perspective, just like
anything, any normalcontraindication of poking a
needle into their body are goingto be the usual
contraindications ultimately.
But you can do some crazy stufflike I've we've dry needled,
like the orbicularis oculi, likethe muscles around the eye, for
(23:43):
like oral or not oral, uh,ocular migraines and stuff.
I've done temporalis before.
Um, I've not done this.
But you can do tmj, uh, likeyour masseter and then your
pterygoids up under the jaw forthose types of things, so people
who grind their teeth or havelike popping and clicking when
they open their jaw, stuff likethat.
You can do the abdominalmuscles.
I'm not certified to do itbecause it takes a lot of
(24:04):
training, because you know yourabs are pretty thin and then
there's, like I don't know, allthese special organs underneath,
so you have to get certified inthat.
But you can drain pretty muchany muscle.
Therapist Jennifer Schmitz (24:13):
Okay , and even for individuals who
have had, like, major surgeriesand there are, like there's been
structural damage, that's beendone.
You know, you've had your hipreplaced or your knee, your knee
redone, or back surgery backsurgery you slipped a disc and
you know your L4 is is jacked upand 20 years ago you had to
have that fixed.
Dr Clayton Dir (24:32):
Okay, I would say too, this is where it kind
of goes back to the whole likeum, parallel with like mental uh
mental approaches and like PTSDand traumatic events.
So needling the way I usuallytalk about it and teach it is
more trigger point style dryneedling, so this muscles and
spasm, poke it, make it go outof spasm.
There's many differentapproaches though, too, where if
you poke a needle into an area,the body's going to see that as
(24:54):
injury and start theinflammatory process, which is
appropriate, right, yep.
And so some people you justneed to poke the area, like
lateral elbow pain, um,sometimes some protocols say
just put like five or sevenneedles in there, let them sit
for a couple minutes and thenpull them all out, um, and then
it's going to like start thisprocess, that your body's going
to go heal it up, um.
Then there's also dry needlingthat they think more into the
(25:15):
fascial system, and so if youjust type in like dry needling
scar on any social media, you'llsee someone with like a knee
scar on the front of their knee,and this will always have to be
once it's closed up, and thegeneral protocol is 12 weeks
post surgery.
But they'll put the needles inand they'll wind them is what
they call it.
They'll twist it and it's kindof like pulling or like up some
of that tissue to help that scarlay down even better and
(25:36):
desensitize it and help the scarbecome nice and smooth instead
of like super keloid and thingslike that.
Now, that's one that I don't dothat much because I don't see
those people in general.
And then I've never really likeput it into practice.
I was taught but I never put itinto practice so I don't have
the reps for it.
And then the last kind ofoption is homeostatic points.
This is where it goes a littlebit more voodoo-y kind of
(25:58):
sounding, but anywhere there's abranch of nerves and so like
your sciatic nerve goes down theback of your leg and behind the
knee it splits, it goes intoyour tibial and fibular nerve we
would call that area kind oflike a little plexus, right
where it branches out.
And there's points there whereif you put the needle somewhat
close to it, you just push it inand then leave it.
It'll desensitize the person'snervous system and kind of bring
(26:18):
it down, just so that they're alittle bit less fight or flight
in the area, a little bit lessprotective so you can most of
the time calm down the painperception from there down or in
that area.
Dr Teralyn Sell (26:29):
I wonder what the intersection is between PT
and mental health.
Like I sit and I think, likehow can mental health
professionals partner with PT?
Because I know that there's.
There can be like oh, go to achiropractor.
Like that's like the only youknow thing that people talk
about.
But I've been thinking aboutthis for quite a while, even
(26:50):
before you came on the show,like what is the partnership
between mental health care andPT?
Dr Clayton Dir (26:57):
Um, I think it would be crucial.
Um, I think the hard part forme and putting it into practice
is y'all are overran.
Like if I want to get anappointment with y'all, it's
like cool, I'll see you in ninemonths.
At least that's the perspective.
Um, that's what's hard is likeyou don't have like your people.
It feels like don't have timeto like set aside and like come
talk to me Just because there'sso many people asking for the
(27:20):
services that you offer.
I've had a hard timecommunicating that way.
And then the second thing iseven if I do have you sold and
you're like yeah, you need to gosee Clayton for your knee pain
and I think this will help breakthrough some of the stuff
you've got going onpsychologically, uh, that's
asking that patient to spendmore time and money, and so then
when you actually get toimplementing it, the barrier
seems like gosh, I just gotta goto all this therapy and out of
(27:41):
the money to do all this.
Uh, is is my other perceptionthere.
So I fully agree with you onpaper.
Right, it's very what's itcalled when you have a bunch of
providers together, like workingtogether?
uh team um kind of like thatthere's like no I don't know.
It's more of a hospital typetermed thing where it's like uh,
multi-disciplinary act, that'sinterdisciplinary
(28:03):
interdisciplinary team.
You're getting all the differentperspectives where, like I told
you, my patients sometimes thatI can tell there's there's a
little bit of emotionalnesswrapped up into this.
Um, I can help you the best Ican.
But there's somebody like y'allwho probably have this very
strategic approach and you'relike, oh, we'll knock this out,
we're going to do step one, steptwo, step three, and I'm over
here like I'll give you a hugand tell you, like gosh, you
(28:26):
know.
Dr Teralyn Sell (28:27):
Which helps.
Calm down, calm down.
You want a hug?
Okay, calm down, calm down.
You want a hug?
Therapist Jennifer Schmitz (28:40):
So can you do a quick?
Uh, can you do a?
Dr Clayton Dir (28:41):
quick PBS special on the difference
between dry needling andacupuncture.
Yeah, for sure.
Uh, the only thing that'ssimilar is the needle.
Uh, we buy the same needles andthat's it.
Um, when it comes toacupuncture, uh, I'll give you
my understanding of it, but Idon't have an education in it
necessarily.
To my my understanding, most ofthe time acupuncture only goes
into the dermis, which is likethe same level of skin that,
like tattoos, go to right, Likeyou're puncturing the skin,
getting a little bit in andyou're leaving it.
(29:01):
They're going to follow more ofthe Chinese or Eastern medicine
approach, where they're lookingat the flow of energy, the flow
of chi.
They're going to look at yourmeridians and they may be poking
your ear to solve, like, yourleft hip problem.
And it's been around for a longtime and a lot of people will
swear by it.
So I'm sure there's some stuffto it.
I just don't know what thosestudies look like.
That's acupuncture, Dryneedling again.
(29:25):
If I kind of keep in the windowof that trigger point method and
treating that way, we areputting the needle all the way
into the muscle and we're tryingto find the dysfunctional
tissue.
Ultimately, I don't put all ofmy like stock in is this tender
to touch?
I don't put it all in the stockof is this muscle dysfunctional
?
Like when you try to use it?
I use three or four differentthings to kind of like cluster
(29:46):
together.
So, for example, if we use thatrotator cuff uh, the super
spinatus one, someone who comesin with shoulder pain, they
can't lift overhead anythingover like 90 degrees of arm
lifting hurts If they put theirelbow at the side and they try
to like open up their arm, whichis called external rotation.
If that hurts, that's startingto tell me like okay, rotator
cuff's probably involved.
And then I go palpate thosetissues and I say, is this
(30:07):
tender, Is this tender?
And they're like, yeah, you'repushing really hard.
And then I like push their,their shoulder and they're like,
oh, wow, that's way different.
You know, the right one makesme want to punch you.
The one that's not hurt feelsfine, and so, and usually I can
feel like a tender top band oftissue.
So you're rubbing over thismuscle and there's like wow, did
you install a metal cable intothis thing?
Like that's where we need to go.
And so that's when I'll takethe needle and I'll tap it in
(30:29):
and I'll usually do what'scalled pistoning, which is where
we kind of go in and out indifferent directions.
We're trying to treat a largesurface area without actually
pulling the needle back out ofthe skin.
Usually what I'll feel is Iwill see and or feel that muscle
twitch and it's super cool.
And if you just type in likedry kneeling twitch, you'll see
it on social media Supersatisfying and you will actually
(30:50):
have the patient say wow,that's recreating my pain, Like
I know you're poking me in theback of the shoulder blade, but
I feel it in the front of myshoulder.
I'm like cool, we're on theright path, this is what we're
looking for.
And you go, you take it out andyou retest.
Therapist Jennifer Schm (31:04):
Usually , the whole process takes five
minutes or less.
I'm just.
It's so hard to not personalizeeverything that you're saying
right now, whether it's formyself and shit that I need to
explore or for people that Ilove.
When you came on before westarted, I was telling you that
I was just in a pain clinic withsomebody very close to me, and
that person has had a couple ofmajor surgeries two on a knee
(31:27):
and then one with a slipped disc.
That happened many, many, manyyears ago.
So there's this chronic backpain that exists as well, and I
went with them because theywanted a holistic perspective on
pain management.
Dr Clayton Dir (31:42):
They also do that a lot of the times with
them.
Dr Teralyn Sell (31:44):
Yes, an advocate.
Therapist Jennifer Schmitz (31:45):
Yeah , and so it was, that's all.
I was right.
And so I went along and ofcourse, I had a visceral
reaction going into the painclinic because of all the damage
that has happened in my traumasfrom just white coats in my
life, which that's a new thingfor me Side story on that,
anyways.
And I'm sitting there andlistening and the individual
said to this person that I loveso much, this is chronic, it
(32:11):
will never heal, it will neverget better.
And sat there listening and I'mlike, yes, I know there are
structural injuries that existhere.
We've had two surgeries on kneein the last year and a half.
We had a major back surgerymany, many, many years ago, 20
years ago.
Right, that exists there.
(32:32):
You've been managed on opiatesfor over 20 years.
That's the treatmentintervention.
Right, is the opiates.
And I'm sitting here listeningto this what.
Dr Clayton Dir (32:43):
So which is a great maker.
Therapist Jennifer Schmit (32:45):
Right .
Oh, I'm sitting here like I kepttelling this person so much
that I love I'd be so carefulnot to say who it is right
Because he'd be so pissed at me.
I'm like revolving door,revolving door, forever consumer
, forever consumer, right.
I'm sitting here like sayingall these things and I'm just
listening and that the verbiagethat's given is this will
forever be, this is degenerative, this will not get better.
We can do all theseinterventions that are going to
(33:07):
kind of make it a little bit,you know like make your pain a
little less, yeah, um, but thisis for your forever sentence,
death sentence.
And I'm just sitting here andI'm like fuck this.
Like from from what perspective?
Oh, from from what perspective?
Oh, I know from whatperspective.
This comes from a very narrowminded, money-making Western
medicine perspective.
Would you say that to somebodyand I'm listening to you here,
(33:29):
talk about these options, whichdry needling was not an option,
given the holistic options.
There were some given, so I waslike, okay, that's great, and
one of them was acupuncture.
But that statement to patientsthis won't get better, it's
degenerative, you will have thisforever.
Dr Teralyn Sell (33:46):
Well, I want to say, hope is also an option.
It's just on right.
Therapist Jennifer Schmitz (33:49):
And it just turned me off so much,
and so I don't know what yourthoughts are on that.
But there's this verbiage thatwe say and that's pain clinic.
This is a pain clinic, doc.
Dr Clayton Dir (33:58):
Right, right well, I mean, like you don't go
to mcdonald's expecting to getsushi right, like what else did?
You expect from a place likethat.
I'm not saying that to you butlike no, you're right, you're
right, keep going with theanalogy you're on and I think
that's why it's important that Ijust shared a post yesterday I
don't even know who it's from.
It said we need more doctors onsocial media, and it talks
(34:18):
about because there's not onlybad information on socials, but
when you actually go into themedical world, that's what you
get like every single time, likeyou can.
Where are you?
Where you guys located at like?
Where was this experience?
At what state?
Therapist Jennifer Schmitz (34:30):
I'm in wisconsin.
Dr Clayton Dir (34:31):
It was here in wisconsin yeah, I'm in kansas
and we have the exact same thing.
Like you know what I mean.
It's.
It's so predictable, um, andexactly what you're going to get
, and so, and what else kills metoo, when you talk about hope
and stuff.
I just shared a post and it gota little bit more traction than
I had anticipated.
Nothing, bonkers.
But I said like here's theadvice I would give as five
years in practice, if I wasn'tafraid of hurting your feelings.
(34:52):
And then the caption said thepain may not be your fault, but
it's your responsibility andyou're the only one that can
change it.
Responsibility, and you're theonly one that can change it.
Therapist Jennifer Schmitz (35:00):
And change requires change.
Yes.
Dr Clayton Dir (35:01):
Yeah, the medical system does such a good
job of saying it's not yourfault, poor you.
You're stuck like this, it'sjust going to happen.
And it's like no, no, like comeinto my clinic, let me look at
things and let me assess you andthen let me show you what you
can do.
Like one of my favorite thingsto do is, as you make someone's
pain, go down, walk out into thegym and say, have you ever
deadlifted before?
(35:21):
And they're like no, doesn'tthat hurt your back?
I'm like well, let's see whathappens.
And I hand them a kettlebell andsay you got a deadlifting 400
pounds.
And I say pick this up and setit down.
They pick it up and they'llhave 50% good form.
Let's say they set it down andI say how much weight do you
think that is 20, 30 pounds,that was 70 pounds.
What Are you serious?
It's like yes, you can deadlift70 pounds, you did it
(35:43):
relatively easy and did you havepain?
And if the answer is no, I'mlike cool, we're going to do
this more to strengthen thesemuscles.
If the answer is yes, then Istart critiquing their form.
And it's also crazy how muchtilt type of thing.
And they're like well, thatdoesn't hurt and that felt a
little bit easier.
It's like do you see howchangeable this is?
And then I then, unfortunately,then it's like okay, now I have
(36:07):
to untie all the shitessentially that this pain
doctor just told this person andpeople don't understand the
weight of that person's opinion,that person's statement right,
when you have a license on thewall and 90 patients in the
waiting room, they think youknow what you're talking about.
And I mean, it's not wrong,they know their stuff.
But it creates such limitingbeliefs in the patient and
(36:29):
that's what pisses me off andthat's what makes me so
frustrated, because it's all ofthat that I have to go and work
and like continuously tell themlike no, like please disregard
what they say.
Like show me your MRI, you know.
Like, show me your x-ray andlet me talk you through what
this actually means.
Cause, degenerative discdisease.
Oh man, so you're saying this isjust going to keep breaking
down?
And then they picture it.
Then they catastrophize it.
(36:50):
Pain gets worse.
They say, oh my gosh, I, I, Ishouldn't move this.
And then there you go into thespiral no-transcript.
Dr Teralyn Sell (37:29):
The lack of hope in, in that idea that you
can't do something is profoundand it eats up the problem.
Yes, it does.
Yes it does, because the thelack of doing something means
her muscles aren't moving andthey're they're.
Basically, you know the musclesare going down and decreasing
(37:50):
and you know.
So now she can't do certainthings that she should have been
able to do before and so, butthat's because the doctors are
telling her you can't.
So if you just blindly listen.
Conversely, there's this womanthat I saw on TikTok I think it
was a while ago and she had andI know this isn't back, but she
had a hip replacement and shewas doing yoga, like a lot of
(38:17):
yoga, and I showed this to mymom because my mom's had knees
and hips and all these things.
She's like the bionic woman,that's what my kid calls her.
But anyway, I said look, I saidI know that you're not going to
be like this woman, but she'shad a lot of things happen to
her too and had a lot ofsurgeries, and she still does
things.
But of course, looking at thatmodel is like I could never do
(38:41):
that and I'm like I, Iunderstand, but you can do
something right and instead ofnothing and I do find this a lot
in the elderly population isthat once they have a surgery,
they become sedentary becausethey're afraid of, you know,
wrecking it, wrecking thesurgery or whatever, because
they've been given the fear fromthe surgeon or from whoever,
(39:04):
that you can't get better oryou're going to hurt yourself
worse.
Dr Clayton Dir (39:07):
Yes, and that's where the hope and the messaging
that we have needs to change,yeah, the narrative that we give
as providers or that theproviders as a whole.
Dr Teralyn Sell (39:18):
Yeah, because Jen and I talk about this all
the time, regaining a sense ofyour personal agency, of like
change.
You are the change agent.
Nobody is going to change thisfor you.
And what message are you goingto start believing about
yourself before you decide toengage in that change?
Are you going to believe thisis hopeless?
Are you going to believe thatyou can do something?
And what?
Dr Clayton Dir (39:38):
what kills me with, like, the two stories that
you can do something, and whatkills me with the two stories
that you guys just told wasabout your parents, right?
Dr Teralyn Sell (39:43):
No, jen, it was not Jen's.
No, we can't out that Huh.
Therapist Jennifer Schmitz (39:51):
Okay .
He already knows.
Dr Clayton Dir (39:54):
Older individuals in our life there
you go, I had a four-year-oldlady in here yesterday who
trains with a personal trainerthree times a week, does water
aerobics two to five times aweek, does Pilates a couple of
times.
And I also treat her and I wassaid first of all I said good
job, by the way, because mostpeople your age they just kind
of quit and you made sure not tostop moving.
I said that's the reason you'restill here.
(40:15):
This girl can still palm thefloor Like she moves really well
.
But her and I kind of went onthis tangent and I said what
pisses me off so much is peopleyour age, I think, are preyed on
significantly.
Because when an 84-year-oldlady comes in and they say they
have knee pain, you are someonewho probably has a decent amount
of money just because youeither have retirements or you
have like social security, youhave something where you've
(40:37):
built up funds over your life,so you probably have money.
You expect to be unhealthybecause you're 84, like yeah,
it's probably wearing down, Iprobably am not healthy,
whatever.
And you're very, veryunfortunately like you just
believe whatever the doctor saysand to none of this is like
that person's fault.
But when you start to see likethis pool of people that you're
(40:57):
like, oh yeah, we could probablyget money on this person pretty
easy.
And you say like, okay, yourknee is wearing down, you
probably just need a total knee.
They say okay, and it's likethat's a multiple thousands, if
not tens of thousands, ofdollars surgery.
And the best part, if you lookat it just from the surgeon
perspective, doesn't matter howlong it lasts.
This person may die in twoyears, completely unrelated,
because you don't have to worryabout longevity.
(41:17):
And then when they get, youknow when they come out of it
they may have some pain.
So now they're going to buythis, and now they're going to
buy this.
And if you know anything aboutsales, the best way to make
money is upselling right like webought this product.
What if we just tack this on?
yeah and next thing, you know,they're two years in and they've
started, you know, threedifferent pharmaceutical
medications.
They're still in pt, they'restill doing this and it's just
like all right, here's thebeginning of the end.
And it just pisses me offbecause when people are in pain
(41:39):
and they go to an ortho, they'relike, okay, we can make the
pain go with surgery.
And it's like 50% of backsurgeries aren't any better at
all.
Dr Teralyn Sell (41:48):
No, and then you find yourself in another
back surgery Exactly After that.
I find that if you have oneback surgery, you're going to
have three more Probably thenext one within two years.
Yeah.
Dr Clayton Dir (41:58):
And it's like cool, this didn't work.
What if we do it?
What if we do it again?
What if we do more of it?
Therapist Jennifer Schmitz (42:02):
Okay , so all right.
So, as as we, as we get nearthe end here, I want to wrap
this into something you wrotefor us before the show.
You, you said you, we need toget better healthcare and that
it's growing.
But as a patient, you need tobe put first.
As the clients, you need tofind a provider that's going to
put you first.
Is this part of the thing thatpeople should be assessing?
(42:25):
When you say put you first, howdoes a patient know if they're
being put first?
Oh, good question.
How do they know that?
Dr Clayton Dir (42:34):
One.
I think it's whether or not theprovider's actually listening.
I'm pretty sure I don'tremember the stat, but I think
it's like 17 seconds before theaverage primary care provider
interrupts them.
The average time spent with apatient in primary care is 2.7
minutes, and so, even if thatperson has a heart of gold, the
provider like.
When you're in a system likethat, it's very hard to stay
(42:57):
positive.
I mean, there's a reason thatour clinic built a system
differently.
I would say that when clientscome in, they fill out their
paperwork.
I usually write up thequestions that I'll have based
on their paperwork, and then Igot this from a continuing ed
course.
They call them asterisk signs,so signs that, like the person
says, I can't do this because ofmy pain, I can't get in and out
(43:17):
of the car, put on my jacket,throw a ball with my kid.
They have something and it'slike cool.
Every time you come in, I willask about this, because it
doesn't matter what I say orwhat I think is getting better.
If you can't feel tangiblechange throughout this process,
then I'm not doing my job.
If you're not getting closer tothe goals you walked in with
and are asking about, then I'mnot putting you first right?
(43:37):
And the thing is is too manytimes I've seen people who go to
the ortho they say look, here'syour knee, let's go and do
surgery.
It's like did we even talkabout this?
Are there other options?
Like, does my opinion matter?
What if I don't want to dosurgery?
What are my options?
And most of the time they justdon't know and so no, this is
the only option, and so that's agood question.
I actually don't know how, likeI don't know a perfect way.
Dr Teralyn Sell (43:59):
I think you did , I think you did and um, I.
I want to just add in thereit's there aren't any other
options that I can do is reallywhat that surgeon is saying,
that I know of Um and so I, butI.
I don't think that that's whatthey say.
They just say there aren't anyother options.
But I wish they would just saythat I know of that I'm capable
(44:21):
of doing.
I wish there was more justtransparency and knowledge and
more I don't know truth.
Dr Clayton Dir (44:30):
Yeah, yeah, just admitting what you don't know
and saying how I help peopleright when you're a hammer.
Everything looks like a nail.
That surgeon is probably goingto suggest surgery.
Therapist Jennifer Schmitz (44:38):
Yes, we've heard that on this show
before A million times.
Dr Teralyn Sell (44:42):
But it's true, it's very true, yeah, so I think
we.
Is there anything else that youwant people to know about the
power of PT that they might notknow?
Dr Clayton Dir (44:56):
I would say, your perceptions of PT.
If they're poor, it's probablya bad PT, not a bad profession,
and you need to find someonewho's going to like sit with you
and help you, Just like.
As I know, the conversationaround therapy in regards to
like mental therapy is if youdon't vibe with the person, go
find someone you vibe with.
I mean, that's the end of it.
And unfortunately, healthcarechange can only come at the pace
that people demand it, and soif you're not going to support a
(45:19):
provider like me or providerslike you guys, then you guys
can't grow.
And so it's kind of like, ifyou're going to advocate for
better healthcare, you have toput your dollars there, you have
to show up in those people'soffices, and someone like myself
I don't use any healthcaredollars Like I go once a year to
make sure like my blood's not,you know, horrible or something,
and so I don't I don't evenhave power to do it, cause like
(45:39):
I don't need much right now.
But when you go sit with thesepeople that you're, you guys are
talking about in those offices,like don't give them your money
, like don't go to that office,like take your bad experience
and give that person a badreview appropriately.
I'm not saying like destroythem, but like make sure that
you're incentivizing the goodproviders to keep doing what
they're doing.
Help those providers provide sothat the dollars can start
(46:02):
coming out of the crappy systemand start building up the better
system.
That's what I'm looking for andthat's what this podcast is
probably all about as well.
Dr Teralyn Sell (46:09):
Yes, I love that idea.
That is a fantastic way to putit, because I agree with that
100%.
And, by the way, most of myhealthcare dollars don't go to
the system either.
Therapist Jennifer Schmitz (46:20):
I know I'm having an issue because
I keep firing all my doctors.
So, I'm running, I'm like, yep,we're out of that realm now
because, I fired pretty mucheverybody so, and that's good.
Ok, like people fire me too,I'm like hey right, all right.
Shop around Like for sure.
Oh, all right.
Well, we've reached the end ofthe show.
Everybody, dr Clayton Durrrhymes with gurr.
(46:42):
Thank you for being on the show, clayton.
It's been great to have you.
Dr Clayton Dir (46:46):
Thank you so much for having me.
This was a blast.
We should do it all the time,every week.
We'll do it every week.
If you need a tri-co-host, letme know.
Therapist Jennifer Schmitz (46:54):
Oh sure you guys.
You are listening to the GaslitTruth Podcast.
You can find us anywhere thatyou listen to podcasts.
Please make sure that you giveus a rating only five stars.
We had someone who gave us fourstars very recently and told us
it's because we talk too much.
So guess what?
Don't listen to the show andyou can find us on any of the
social medias.
And if you want to send us yourGaslit Truth stories, please do
(47:16):
so at thegaslittruthpodcast atg.
You have been gaslit into believing that you
need meds, injections andsurgery for your chronic pain.
We are your whistleblowingshrinks, dr Tara Lynn and
therapist Jen, and you arelistening to the Gaslit Truth
Podcast.
Welcome aboard everyone.
Today we have a special guest.
I've been waiting a while forthis one, actually.
We've been trying to sort thisone out for a few months now.
(00:22):
So Dr Clayton Durr.
Clayton Durr is a physicaltherapist, a doctor, a physical
therapist.
That's important to point out.
He is a performance physicaltherapist who specializes in
performance.
He has worked with national andworld champion athletes in
powerlifting, strongman,crossfit and many other sports.
(00:43):
That's really cool.
He also has a focus in chronicpain and patients who have been
dismissed by the medical systemor gaslit and being told they
are fine.
He is the host of the podcastHeal Without Harm, where he
discusses the pitfalls of themedical system and bringing on
guests who are actively buildinga better system.
(01:04):
Welcome to the show, dr Clayton.
Dr Clayton Dir (01:07):
Thank you so much, both of you, for having me
.
I've been following yourcontent for quite some time and
I'm catching myself watchingbeing like hell.
Yeah, yeah, I feel like we havesimilar paths, different genres
maybe.
Dr Teralyn Sell (01:19):
For sure.
I think there are so manydifferent specialties that Jen
and I are running into that arethinking very similarly now, so
it's really cool when they kindof cross and meet together.
So excited to have thisconversation, particularly about
chronic pain, because I don'tthink we've had that before,
have we Jen?
I don't think we've talkedabout chronic pain.
No, it's a new one.
(01:40):
Yes, it's a new one, and I knowthat a lot of our clients have
a lot of chronic pain andthey've been through the ringer
in pain clinics and things likethat.
So I'm really stoked to listento what you have to say about
this, clayton.
Dr Clayton Dir (01:58):
For sure.
No, and I'm excited to learn alittle bit from y'all, because
there's sometimes where patientswill come in and I can tell
that it's almost like a sensoryprocessing disorder of some sort
, or at least that's playinginto it, where the tissue's
doing fine but you're stillfeeling pain and I know I can
help, but I know I'm not goingto be like the root cause fixer
and so trying to find someone toput them in front of, to finish
(02:20):
that out or assist in that careis something that I'm still
actively looking for.
Therapist Jennifer Schmi (02:26):
That's intriguing.
Dr Clayton Dir (02:27):
That is really intriguing, yes, yeah.
Therapist Jennifer Schmitz (02:29):
So the tissues themselves heal and
you can see that.
And yet there is still thisviewpoint that they take of pain
and there is still a subjectivestatement that there's still
pain levels there.
Dr Clayton Dir (02:43):
Have you guys learned about the homunculus of
the brain?
Does that sound familiar?
Therapist Jennifer Schmitz (02:46):
Does not, did you say, monkey?
Dr Clayton Dir (02:49):
Homunculus Very, very similar.
There's a couple of sharedletters in there.
You don't have to validate.
Therapist Jennifer Schmit (02:54):
Thank you, that's cute, oh, I like
you, it's not quite genuineIdiot.
Stop, it All right the.
Dr Clayton Dir (03:01):
All right.
The brain has a map of the body, and if you just type in
homunculus if you can figure outhow to spell it into Google
you'll see that different partsof the brain perceive sensation
from different parts of the body.
The hands and the feet take upa huge amount of surface area in
the brain, because that's wherewe get most of our sensory from
right.
If I drew the letter four onyour back with, like my
fingernail, you may be able torecognize it, but if I drew it
(03:22):
on your hand, you would knowexactly what you're feeling.
And so the brain has its ownperception of the body, and so
sometimes it gets like thislearned, almost like a learned
behavior, Like if you touch myarm it's going to hurt, so
please don't touch it, and thenthat tissue heals.
But you still think if this armgets touched it's going to hurt
, and so we have to work throughthat.
But sometimes I'm not the bestperson for that because I don't
know how to navigate it or Idon't have the same, maybe
(03:44):
information you guys have inyour brain or I don't know how
to unfold it and have thatconversation.
But most of the time I justlean on exercise and
weightlifting and be like, hey,we're just going to work through
this and kind of through thatprocess, you'll get more
comfortable.
Therapist Jennifer Schmitz (04:00):
It reminds me a little bit of how
traumatic memories are stored intrauma storage right, and how
there may not be a threat andthere is nothing there, like in
front of you, and yet we stillperceive there to be, that,
there for us.
Dr Teralyn Sell (04:15):
Wait, I have a lived experience, a recent one,
because my front tooth cap justcame out right and so I had to
go to I know right.
Anyway, I had to, had to go tothe dentist and she was working
on it and it was so sensitiveand she kept saying this is
weird, because most people don'thave this level of sensitivity
whatever.
And I'm thinking well, I do,but the thing is is that she
(04:37):
would get close to it and itfelt like a jolt of lightning
was, and she was like I barelyeven touched your tooth.
It was like this anticipatory,like you know, and I felt it,
like I felt that pain where itreally wasn't even there.
It was like this and I keptsaying to myself this is
anticipatory pain, this isanticipatory pain Like don't do
(04:57):
it, don't do it.
So I feel like this is like asimilar concept in real world,
like you kind of anticipate thatpain happening.
Therapist Jennifer Schmitz (05:08):
It's along the same line Well, you
got to get your monkey checked.
Then, terry, Get your monkeychecked.
This is seriously.
Dr Clayton Dir (05:12):
It's along the same lines on why amputees still
have like phantom pain, becausethe brain still has the map of
that limb, even though it's notthere.
Therapist Jennifer Schmitz (05:20):
Okay , phantom limb pain.
I know that.
I remember that from Psych 101.
Dr Teralyn Sell (05:39):
Okay, phansom, limb pain I know that, I
remember that from Psych 101physical pain when you have
physical pain heightened, youwill have more emotional pain.
When you have emotional painheightened, you will have more
physical pain.
It's like this feedback loopsystem and I feel like some of
that was anticipatory pain orhistoric pain that you expect to
(06:00):
happen again, or the beliefthat it will never be gone so
you have to live with it forever.
So you know the head isconnected to the body.
Essentially is the moral ofthat?
Dr Clayton Dir (06:11):
Well, then you tell that patient like, oh, by
the way, this tissue is fine, Idon't know why you're still in
pain.
And then that's the end of theconversation.
And then it's like, well, whatam I supposed to do with this?
And so I think even there wasone gentleman actually who came
in.
This was within my first sixmonths of getting out of school,
uh, when I felt like I stillhad no idea what I was doing.
(06:31):
He came in with shoulder painand the story.
I saw him in January but hestarted having pain in, I think,
october.
He got the flu shot and he'snot saying that's what caused
the pain, but that's when hestarted noticing it.
At least it created somesoreness.
Never really went away.
He got that, I believe, inOctober.
November came around aboutThanksgiving.
He went to a doctor.
The doctor said oh, I think you.
He went to two doctors, I don'tremember which order he got the
(06:51):
diagnosis in, but one of themsaid I think you tore something
a little bit, but otherwiseyou'll be fine, it'll heal, kind
of thing, somewhat like.
Sent him off, went a couple ofweeks, pain was still there,
slash getting worse.
Went to another doctor and theyjust said oh, you have
tendonitis and kind of like,dismissed him again, not
necessarily rudely, but like,sent him on, was like, oh,
you'll be okay.
It was christmas eve.
(07:11):
His dad passed away and heremembers that between christmas
eve and like new year's day hewas moving a ton of stuff out of
his dad's house and somebodygoes isn't your shoulder hurting
?
Like you're moving these boxeswithout issue.
He's like oh my gosh, I totallyforgot that I was having
shoulder pain.
And within a day, like it waslike 10 times worse than it was.
He came into my office.
He was a classic, like bluecollar type dude.
(07:32):
He he lives on like a smallfarm.
He's got, you know, the sidebeside, side by side uh, almost
monster truck, golf cart lookingthings like.
The dude is like veryphysically active.
He was also a welder.
Well, I saw him for 30 minutes,by the way, which is normally
an hour eval.
This is like very physicallyactive.
He was also a welder.
Well, I saw him for 30 minutes,by the way, which is normally
an hour eval.
This is like a half hour freeconsult to see if we're a good
fit.
And he was telling me the storyand he's like yeah, I'm a welder
and sometimes I'll have to bein really weird positions, like
(07:54):
they'll be on the ladder, leanedover here, arm you know,
finagled through this like smallhole to weld a.
He said I just don't know ifI'm going to be able to keep
doing my job.
It hurts so bad to go to work.
And I kept asking questions andthen I think the thing that
really rested on his heart washe had a four-year-old son.
He's like I want to be hisbaseball coach.
I want to take him through, youknow, like baseball.
(08:21):
He's like, and I'm afraid thatwon't happen now.
He's like my shoulder hurts.
Know what's hurting you?
Because you're passing all mytests Range of motion is good,
strength is good, mobility isgood.
Me palpating on your tissues isgood.
Like I don't know what's goingon right now, but come back
later this week, let's do a fulleval and let's start treating
the shoulder.
Three days later he came in zeropain, like he had no pain left
at all, and I said, okay, let'stry to hurt you.
(08:41):
Essentially I was like let'slike, do this strength test and
like push it hard, let's playcatch with a ball, but let's
make it a four pound ball.
Like let's push these things tothe limits.
Never saw him again after that,never had pain again and I was
like what the heck was this Like?
Like physically did not touchhim, had a conversation with him
, essentially like validatedwhat he was feeling, saying like
I know they say this, but allmy tests are showing this, let's
(09:06):
go push your tissues to thelimit and see what happens.
And that unlocked like you weretalking about the emotional
side of things and theperspective or perception of
pain, anticipation of pain, andthen also getting like
incorrectly validated,potentially from other doctors,
like when you have a, an imagethat shows a tear, you're like,
oh shit, like what do I do now?
Like what am I losing now?
(09:27):
Am I going to lose my job?
Am I going to lose my abilityto play with my kids?
And then that likecatastrophizes and goes from
there, and so that was a reallycool turning point.
Thankfully, within my firstyear of practice, that really
opened my eyes.
Therapist Jennifer Schmitz (09:38):
So okay.
So does this lead, as we jumpright into this then, does this
lead into the the statement thatyou had made to us that surgery
should never, most of the time,be the first option?
Dr Clayton Dir (09:50):
unless it's like if we don't do this in the next
hour, you're going to lose theability to walk, type of stuff,
or like dramatic, you know, caraccidents and stuff.
Yes, the people who, like theydon't really remember when their
shoulder pain came on, or likethe knee just started bothering
them they started running sixmonths ago and about three
months in my, my knee startedbothering me a little bit those
are the people that end upoftentimes showing up in an
(10:11):
ortho office and getting asurgery.
Or they have back pain and youknow, they end up getting a
surgery.
Those are the people that I'mI'm speaking to now.
Where surgery is.
Often it's this classicalgorithm right, I go to the
doctor.
They take an x-ray.
They don't find anything.
They prescribe opioids andmuscle relaxers.
That doesn't work.
They say, okay, let's get yousigned up for an injection.
They get the injection.
I would say it seems like 10 to15% of the people that come
(10:35):
into my office so a biasedsample but that come into my
office and get an injection.
They report wow, this hurts sobad.
I felt tingles down my leg.
Like this made everything worse, like those are the reports
that I get more often than rare,probably just more in the
uncommon category.
But if that doesn't work, thenthey say all right, let's sign
you up for an ortho consult.
And I think the ortho consultshould be like let's investigate
(10:58):
this and see what's going onfrom an orthopedic standpoint.
Unfortunately, it's more of.
Here's what your MRI shows.
When do you want to havesurgery?
Dr Teralyn Sell (11:11):
And it's almost like no in between.
No, they go straight to surgery.
Dr Clayton Dir (11:13):
It's like you're consulting for surgery at that
point, Exactly.
So a lot of times PT is notrecommended.
I think it's becoming morerecommended, thankfully, kind of
, because insurance is actuallysomewhat requiring it.
However, the way it is sold isthe doctor goes.
I mean you can try PT for sixweeks, or you need to try it
first, but then go ahead andsign up and it's just like cool.
Therapist Jennifer Schmi (11:32):
Thanks , bro, Well and you know, I just
went through this with my knee,and it was one of those things
where I woke up and there it isLike I don't have some great
awesome thing.
That happened where I was likecrossfitting and blew my left
knee out when I was, you know,doing some.
That was none of that good shit, right?
So what's interesting, too, isthere's this insurance, and you
(11:54):
talk a lot about insurance too,so we dive right into this why
insurance does not have yourback in this case.
Right, you shared this with us,right, like, you can tell us
more about why you say that?
But even when it comes to PT,there's limitations on it.
Here is the parameters of howlong you get PT, and then that's
it.
And so I often question that,too, where you get your six
(12:16):
sessions of PT and you're done,and then patients are done.
You're just, you're done.
Dr Clayton Dir (12:22):
Yeah, and a lot of times they're no better, um,
or they're just a little better,right, right.
And what's frustrating here'smy thought that like goes into
the conspiracy type of thing.
Dr Teralyn Sell (12:31):
But not even conspiracy, but it's like
realistic at the same time.
Therapist Jennifer Schmitz (12:35):
This is very real.
Dr Clayton Dir (12:35):
It is.
Who makes money from theinsurance or from, like big
pharma, who makes money off ofPT?
Like nobody, like not thephysical therapist, that's right
, of course no.
In the nin like nobody like,not the physical therapist,
that's of course no.
In the 90s they made more money.
In the 1990s, a bachelor'sdegree in physical therapy got
you more money per patient thanin 2025, where I had to do a
seven-year degree and drop over100k yes so because, because
(12:57):
physical therapists now themajority of them are required to
have a correct yeah, well, Ihad the bachelor's and were
grandfathered in, or themaster's Right.
Dr Teralyn Sell (13:07):
So that's kind of a newer-ish.
I mean I'm old, but that's kindof newer and I would say I was
even below normal, like mostpeople.
Dr Clayton Dir (13:12):
I think the average there was I can't
remember the website, but therewas a website that helped PTs
pay off debt.
But they helped everybody, butprimarily 150 to 170 in order of
hundreds of thousands ofdollars of debt for PT.
And then we come out and wemake 60 to 80.
Like my brother graduated fromengineering school at four years
(13:34):
and they're making 80 K twoyears out of school and I'm like
right.
I wish I would just be okay withsitting at a desk all day.
That'd be nice.
Not to dismiss them ordiscredit them, but like that's,
that's a way better.
Dr Teralyn Sell (13:51):
We understand, we, uh, yes, we totally
understand that.
So I want to circle back to thestatement that you said.
Sometimes it's it's the waythat it's sold.
Um, that the intervention, theway that the intervention is
sold is, is very important, andI think about this as you're
talking.
I was like, yeah, PT is kind oflike mental health, kind of
like the red haired stepchild ofthe medical model, if you will
Like, because we're often thelast sold to for, especially for
(14:16):
pain patients.
Well, you could go see atherapist what do you think?
It's all in my head.
And then suddenly that thatpatient doesn't want to see a
therapist.
They don't want that andthey're resisting pretty much
everything because they've beensold this idea and also the way
other interventions arepresented to them as being, well
(14:37):
, you could try it, but right,Kind of like physical therapy.
Dr Clayton Dir (14:42):
Yeah, honestly, I, uh, I I'm a huge analogy and
metaphor type person.
Um, it's the way my brain worksand I think it's the best way I
can relate to people.
And I was just listening toSimon Sinek, uh, a couple of
days ago, and I love the way hetalks on a lot of stuff, and
there was things that he wassaying that resonated a lot with
me, and he talked about how, in2020, everything got blown up.
(15:04):
His business life was goingdown.
He's like yet I had the besttime of my life.
He's like the amount of problemsthat I had to solve and the
challenges that were faced infront of me.
Although it was a lot ofnegative, it was enjoyable and I
liked the flow state that I wasin and all that.
And I think that's how it isfor me.
When it's like the moreproblems that show up from a
high perspective on you know ourtype of conversations, trying
(15:26):
to change public, uh perceptionand stuff like that or even just
when someone comes in and I'vehad somebody sit in front of me
and say how many times do I haveto come here before I get my
mri?
Dr Teralyn Sell (15:35):
oh yes, what do you think that's gonna?
Dr Clayton Dir (15:37):
give you, you know, and what I enjoy about
that, though, is like okay, cool, the difficulty level in
today's case is expert mode.
This person thinks you areworthless and this is not going
to be helpful at all, and I'mlike, just sit back and like I'm
going to sell you on this Now.
Some people are just not goingto be sold, but I enjoy that
challenge now, where it used tointimidate the absolute hell out
of me, where I will use theirown reasoning to like, get them
(15:59):
to be back on my side.
Like, what do you think the MRIis going to give you?
Well, it's going to tell mewhat tissue is wrong.
Okay, so do you believe thattissue is the reason you're in
pain?
Well, sure that you know.
It says my supraspinatus isslightly torn.
Okay, let's test it.
I've got three tests to test andsee if that tendon is
(16:19):
problematic or weak or painful,and then we'll go from there
tell you right now, because youcan lift your arm.
No, I don't think it'scompletely ruptured, and so
you're going to get way betteroutcomes by going through PT and
letting it heal.
Do you want to be in a you know, in a sling for the next eight
weeks?
No, can you do your job likethat?
No, okay, cool, so stick withme, let's save you time.
Money's get to this, you know.
And then we go one step further, and in that session I will
(16:46):
have a test that hurts, or teststhey can't do right, a range of
motion test, a strength test,something like that and then I
will find the tissue that Ithink is wrong and I will dry
needle it.
Are you guys familiar at allwith dry needling?
Dr Teralyn Sell (16:56):
So I've never had dry needling.
I've heard of it.
If you want to explain that alittle bit, I think that would
be an appropriate thing to do,for sure.
Dr Clayton Dir (17:03):
I'll circle back to it right after I finish this
kind of like little storyline.
So I will dry needle thatmuscle and let's say it was
eight out of 10 pain once theygot to like 90 degrees of
lifting their arm.
So they get up and they'repointing to the side and that
hurts eight out of 10 pain.
We dry needle the muscles thatI found to be problem and we
retest and you see their face goup to 90 degrees in that
anticipatory pain that you'retalking about.
And then you see this like ohshit, and they're like who are
(17:27):
you?
I'm a magician.
And they get like 160 degrees,like almost up to their ear, and
they're like this hurts likethree out of 10.
Like what did you do?
And it's like, oh, I got thatmuscle to essentially like calm
down, I changed your painperception and then it got you
to move it.
I you still get surgery nowsignificantly with with that.
(17:56):
So let's get after this, youknow.
And then there, and so that'swhat I've really with initial
eval.
So, going back to the dryneedling, I love how many great
inventions or findings orcomplete accidents.
And so they actually found dryneedling by, they were doing a
study and they're doing triggerpoint injections.
So injections on trigger pointsare like knots in the muscle
(18:17):
and they of course do like Idon't know, double blind or
whatever.
Some people get injected, somedon't.
Well, the people that gotinjected sorry, the people that
got a needle but no injectiongot better.
Because when you put a needleinto a muscle that is in a
trigger point or in spasm, if wewant to think of it this way,
like, imagine like 10 of thesemuscle fibers are stuck in
(18:37):
cramping.
They're just turned on, theycan't turn off.
That's where a lot of your painis coming from and your
dysfunction.
And then we have to figure outwhy.
But that dysfunction is stuck.
If you just poke it with aneedle, it disrupts that spasm.
Usually it is temporary.
You'll get two to five daysrelief from the first session of
dry needling.
But when I put that needle inthere you'll get this twitch and
cramp, like sensation, and thenit'll relax and you get what we
(19:00):
call a therapeutic window,generally in the first sessions,
of about two to five days ofless pain with movement, less
pain when using that muscle,stretching it, strengthening it,
whatever it may be, and that'swhat I tell them.
I said I can dry needle youevery week, give you no other
instructions and I'llpractically be a chiropractor
who pops your back.
You just keep coming back.
I'll keep you know, but if youwant to solve this thing long
term, take advantage of the timethat I just gave you and go do
(19:22):
the exercises I recommend toactually solve the problem in
this muscle and make it not goback into spasm.
That's how you stop seeing me.
Dr Teralyn Sell (19:36):
That's in your life again without pain, and so
it gives them the power.
But I'm helping them shortcut.
I'm just enamored by thisbecause I keep rolling through
my brain on how many peopledismiss PT.
And by the way, I've dismissedPT.
I have.
Dr Clayton Dir (19:48):
Honestly, to give you some credit, I dismiss
a lot of PTs when I'm the thirdone they saw and they're like
why is this so much different?
And I'm like what exerciseswere you doing?
And they hand me a 1980s printoff.
That's been 17 times.
And it's like stretch yourcalves, stretch your quads,
stretch your hamstrings, stretchyour hips, do the pigeon
stretch?
And I'm like, yeah, none ofthose are going to help you.
(20:08):
And they're like they don't.
And I'm like how long does ittake you?
28 minutes, like I would quittoo.
And so.
I'm trying to decide is it the?
Orthos and surgeons giving us abad name, or is it other
physical therapists?
And a lot of the times I wouldsay some, not a lot of times,
but it seems like half the timeit's PTs and corporate medicine,
whether they want to be thereor not, where they have to see
(20:28):
two or three people an hour, andso then they just default to
like, well, let me just show up,hand the piece of paper, tell
them, yeah, it's probably thattissue, and then not actually
solve problems.
Therapist Jennifer Schmitz (20:37):
So it's not individualized is what
you're saying.
Dr Clayton Dir (20:42):
Most people it's not no.
So our clinic is cash-based.
We're out of network and we seefive to eight people a day per
provider and my boss was thesixth person to join a
mastermind and PTs like us, ptsthat run clinics like this.
There's now over 200 people inthat mastermind and they have a
(21:03):
course where they walk peoplethrough a three month process on
how to start a clinic like thisand run it.
They've now helped over athousand clinics throughout the
nation.
So it's coming like things arehappening right and so PTs are
getting out of that like millran PT.
It's coming around and so thenit's like on TikTok.
One of the best ways I've foundto help people is show them what
(21:24):
I do.
Kind of like you guys talkabout what you do and then
they're like hey, can you helpme?
I'm like I'm in Wichita, whereare you?
Boston?
Cool, can't help you.
And I actually went to thisfacebook group of 6 000
providers and I said can youguys please fill in this excel
spreadsheet for me?
And so I will go on there, findsomebody in boston.
I will kind of like verifytheir website and you can
usually tell the differencebetween corporate medicine and
(21:45):
like one of these guys and I'llsay, hey, check out, you know,
move better pt on north fourthavenue, whatever, and they'll be
like great.
And then month later youknow'll see in that Facebook
group, whoever sent me somebodyin Boston, they said they saw
somebody on TikTok.
Thanks for the referral.
That's been my attempt to tryto get people to more PT and
(22:05):
validating that like, yeah, Iwould have quit the PT that you
tried the last three times aswell.
Therapist Jennifer Schmit (22:09):
Which would be the more traditional.
As you say it right, the waythat traditional PT can fail
patients.
This is kind of what you'retalking about.
Dr Clayton Dir (22:17):
Exactly, yeah, they're not helping people, but
it's because insurance stillpays for it.
Insurance still reimburses.
If I put an ice pack onsomebody's back, they'll give me
$12.
Therapist Jennifer Schmitz (22:29):
Who shouldn't do this?
Who can't do dried needling.
Dr Clayton Dir (22:33):
What kinds of patients?
Therapist Jennifer Schmit (22:34):
can't do that, like who can't do
dried needling.
Oh, good question.
Dr Clayton Dir (22:35):
Can't do that.
Yeah, there's not manycontraindications.
Pregnancy if you're going to bedoing any sort of dry needling
around the area, like if you'redry needling their calf and
stuff, you should be fine.
I would say that we still jointhe whole like don't do anything
to this lady in the firsttrimester, cause you never know
what could happen.
But I've, I just straight updon't dry needle anybody who's
pregnant.
And plus we've got now a pelvicfloor specialist who takes on
(22:57):
those gals.
If these people have asuppressed immune system,
autoimmune disorders, thingslike that, we're going to be
very cautious, potentially justnot do it at all.
Needlephobic they're scared ofneedles.
I've got one gal actuallycoming in today that she still
won't let me dry needle her.
Dr Teralyn Sell (23:18):
I'm like I promise you it will make your
hip better, but we don't like.
Dr Clayton Dir (23:20):
I'm like gradual , informed nudging, uh type, but
I don't want to make your ptstworse at the same.
Yeah, exactly.
And then, um, if there's activeinfection in the area, if
they're on like blood thinners,will be a little bit more
cautious.
I mean honestly, like from amedical perspective, just like
anything, any normalcontraindication of poking a
needle into their body are goingto be the usual
contraindications ultimately.
But you can do some crazy stufflike I've we've dry needled,
like the orbicularis oculi, likethe muscles around the eye, for
(23:43):
like oral or not oral, uh,ocular migraines and stuff.
I've done temporalis before.
Um, I've not done this.
But you can do tmj, uh, likeyour masseter and then your
pterygoids up under the jaw forthose types of things, so people
who grind their teeth or havelike popping and clicking when
they open their jaw, stuff likethat.
You can do the abdominalmuscles.
I'm not certified to do itbecause it takes a lot of
(24:04):
training, because you know yourabs are pretty thin and then
there's, like I don't know, allthese special organs underneath,
so you have to get certified inthat.
But you can drain pretty muchany muscle.
Therapist Jennifer Schmitz (24:13):
Okay , and even for individuals who
have had, like, major surgeriesand there are, like there's been
structural damage, that's beendone.
You know, you've had your hipreplaced or your knee, your knee
redone, or back surgery backsurgery you slipped a disc and
you know your L4 is is jacked upand 20 years ago you had to
have that fixed.
Dr Clayton Dir (24:32):
Okay, I would say too, this is where it kind
of goes back to the whole likeum, parallel with like mental uh
mental approaches and like PTSDand traumatic events.
So needling the way I usuallytalk about it and teach it is
more trigger point style dryneedling, so this muscles and
spasm, poke it, make it go outof spasm.
There's many differentapproaches though, too, where if
you poke a needle into an area,the body's going to see that as
(24:54):
injury and start theinflammatory process, which is
appropriate, right, yep.
And so some people you justneed to poke the area, like
lateral elbow pain, um,sometimes some protocols say
just put like five or sevenneedles in there, let them sit
for a couple minutes and thenpull them all out, um, and then
it's going to like start thisprocess, that your body's going
to go heal it up, um.
Then there's also dry needlingthat they think more into the
(25:15):
fascial system, and so if youjust type in like dry needling
scar on any social media, you'llsee someone with like a knee
scar on the front of their knee,and this will always have to be
once it's closed up, and thegeneral protocol is 12 weeks
post surgery.
But they'll put the needles inand they'll wind them is what
they call it.
They'll twist it and it's kindof like pulling or like up some
of that tissue to help that scarlay down even better and
(25:36):
desensitize it and help the scarbecome nice and smooth instead
of like super keloid and thingslike that.
Now, that's one that I don't dothat much because I don't see
those people in general.
And then I've never really likeput it into practice.
I was taught but I never put itinto practice so I don't have
the reps for it.
And then the last kind ofoption is homeostatic points.
This is where it goes a littlebit more voodoo-y kind of
(25:58):
sounding, but anywhere there's abranch of nerves and so like
your sciatic nerve goes down theback of your leg and behind the
knee it splits, it goes intoyour tibial and fibular nerve we
would call that area kind oflike a little plexus, right
where it branches out.
And there's points there whereif you put the needle somewhat
close to it, you just push it inand then leave it.
It'll desensitize the person'snervous system and kind of bring
(26:18):
it down, just so that they're alittle bit less fight or flight
in the area, a little bit lessprotective so you can most of
the time calm down the painperception from there down or in
that area.
Dr Teralyn Sell (26:29):
I wonder what the intersection is between PT
and mental health.
Like I sit and I think, likehow can mental health
professionals partner with PT?
Because I know that there's.
There can be like oh, go to achiropractor.
Like that's like the only youknow thing that people talk
about.
But I've been thinking aboutthis for quite a while, even
(26:50):
before you came on the show,like what is the partnership
between mental health care andPT?
Dr Clayton Dir (26:57):
Um, I think it would be crucial.
Um, I think the hard part forme and putting it into practice
is y'all are overran.
Like if I want to get anappointment with y'all, it's
like cool, I'll see you in ninemonths.
At least that's the perspective.
Um, that's what's hard is likeyou don't have like your people.
It feels like don't have timeto like set aside and like come
talk to me Just because there'sso many people asking for the
(27:20):
services that you offer.
I've had a hard timecommunicating that way.
And then the second thing iseven if I do have you sold and
you're like yeah, you need to gosee Clayton for your knee pain
and I think this will help breakthrough some of the stuff
you've got going onpsychologically, uh, that's
asking that patient to spendmore time and money, and so then
when you actually get toimplementing it, the barrier
seems like gosh, I just gotta goto all this therapy and out of
(27:41):
the money to do all this.
Uh, is is my other perceptionthere.
So I fully agree with you onpaper.
Right, it's very what's itcalled when you have a bunch of
providers together, like workingtogether?
uh team um kind of like thatthere's like no I don't know.
It's more of a hospital typetermed thing where it's like uh,
multi-disciplinary act, that'sinterdisciplinary
(28:03):
interdisciplinary team.
You're getting all the differentperspectives where, like I told
you, my patients sometimes thatI can tell there's there's a
little bit of emotionalnesswrapped up into this.
Um, I can help you the best Ican.
But there's somebody like y'allwho probably have this very
strategic approach and you'relike, oh, we'll knock this out,
we're going to do step one, steptwo, step three, and I'm over
here like I'll give you a hugand tell you, like gosh, you
(28:26):
know.
Dr Teralyn Sell (28:27):
Which helps.
Calm down, calm down.
You want a hug?
Okay, calm down, calm down.
You want a hug?
Therapist Jennifer Schmitz (28:40):
So can you do a quick?
Uh, can you do a?
Dr Clayton Dir (28:41):
quick PBS special on the difference
between dry needling andacupuncture.
Yeah, for sure.
Uh, the only thing that'ssimilar is the needle.
Uh, we buy the same needles andthat's it.
Um, when it comes toacupuncture, uh, I'll give you
my understanding of it, but Idon't have an education in it
necessarily.
To my my understanding, most ofthe time acupuncture only goes
into the dermis, which is likethe same level of skin that,
like tattoos, go to right, Likeyou're puncturing the skin,
getting a little bit in andyou're leaving it.
(29:01):
They're going to follow more ofthe Chinese or Eastern medicine
approach, where they're lookingat the flow of energy, the flow
of chi.
They're going to look at yourmeridians and they may be poking
your ear to solve, like, yourleft hip problem.
And it's been around for a longtime and a lot of people will
swear by it.
So I'm sure there's some stuffto it.
I just don't know what thosestudies look like.
That's acupuncture, Dryneedling again.
(29:25):
If I kind of keep in the windowof that trigger point method and
treating that way, we areputting the needle all the way
into the muscle and we're tryingto find the dysfunctional
tissue.
Ultimately, I don't put all ofmy like stock in is this tender
to touch?
I don't put it all in the stockof is this muscle dysfunctional
?
Like when you try to use it?
I use three or four differentthings to kind of like cluster
(29:46):
together.
So, for example, if we use thatrotator cuff uh, the super
spinatus one, someone who comesin with shoulder pain, they
can't lift overhead anythingover like 90 degrees of arm
lifting hurts If they put theirelbow at the side and they try
to like open up their arm, whichis called external rotation.
If that hurts, that's startingto tell me like okay, rotator
cuff's probably involved.
And then I go palpate thosetissues and I say, is this
(30:07):
tender, Is this tender?
And they're like, yeah, you'repushing really hard.
And then I like push their,their shoulder and they're like,
oh, wow, that's way different.
You know, the right one makesme want to punch you.
The one that's not hurt feelsfine, and so, and usually I can
feel like a tender top band oftissue.
So you're rubbing over thismuscle and there's like wow, did
you install a metal cable intothis thing?
Like that's where we need to go.
And so that's when I'll takethe needle and I'll tap it in
(30:29):
and I'll usually do what'scalled pistoning, which is where
we kind of go in and out indifferent directions.
We're trying to treat a largesurface area without actually
pulling the needle back out ofthe skin.
Usually what I'll feel is Iwill see and or feel that muscle
twitch and it's super cool.
And if you just type in likedry kneeling twitch, you'll see
it on social media Supersatisfying and you will actually
(30:50):
have the patient say wow,that's recreating my pain, Like
I know you're poking me in theback of the shoulder blade, but
I feel it in the front of myshoulder.
I'm like cool, we're on theright path, this is what we're
looking for.
And you go, you take it out andyou retest.
Therapist Jennifer Schm (31:04):
Usually , the whole process takes five
minutes or less.
I'm just.
It's so hard to not personalizeeverything that you're saying
right now, whether it's formyself and shit that I need to
explore or for people that Ilove.
When you came on before westarted, I was telling you that
I was just in a pain clinic withsomebody very close to me, and
that person has had a couple ofmajor surgeries two on a knee
(31:27):
and then one with a slipped disc.
That happened many, many, manyyears ago.
So there's this chronic backpain that exists as well, and I
went with them because theywanted a holistic perspective on
pain management.
Dr Clayton Dir (31:42):
They also do that a lot of the times with
them.
Dr Teralyn Sell (31:44):
Yes, an advocate.
Therapist Jennifer Schmitz (31:45):
Yeah , and so it was, that's all.
I was right.
And so I went along and ofcourse, I had a visceral
reaction going into the painclinic because of all the damage
that has happened in my traumasfrom just white coats in my
life, which that's a new thingfor me Side story on that,
anyways.
And I'm sitting there andlistening and the individual
said to this person that I loveso much, this is chronic, it
(32:11):
will never heal, it will neverget better.
And sat there listening and I'mlike, yes, I know there are
structural injuries that existhere.
We've had two surgeries on kneein the last year and a half.
We had a major back surgerymany, many, many years ago, 20
years ago.
Right, that exists there.
(32:32):
You've been managed on opiatesfor over 20 years.
That's the treatmentintervention.
Right, is the opiates.
And I'm sitting here listeningto this what.
Dr Clayton Dir (32:43):
So which is a great maker.
Therapist Jennifer Schmit (32:45):
Right .
Oh, I'm sitting here like I kepttelling this person so much
that I love I'd be so carefulnot to say who it is right
Because he'd be so pissed at me.
I'm like revolving door,revolving door, forever consumer
, forever consumer, right.
I'm sitting here like sayingall these things and I'm just
listening and that the verbiagethat's given is this will
forever be, this is degenerative, this will not get better.
We can do all theseinterventions that are going to
(33:07):
kind of make it a little bit,you know like make your pain a
little less, yeah, um, but thisis for your forever sentence,
death sentence.
And I'm just sitting here andI'm like fuck this.
Like from from what perspective?
Oh, from from what perspective?
Oh, I know from whatperspective.
This comes from a very narrowminded, money-making Western
medicine perspective.
Would you say that to somebodyand I'm listening to you here,
(33:29):
talk about these options, whichdry needling was not an option,
given the holistic options.
There were some given, so I waslike, okay, that's great, and
one of them was acupuncture.
But that statement to patientsthis won't get better, it's
degenerative, you will have thisforever.
Dr Teralyn Sell (33:46):
Well, I want to say, hope is also an option.
It's just on right.
Therapist Jennifer Schmitz (33:49):
And it just turned me off so much,
and so I don't know what yourthoughts are on that.
But there's this verbiage thatwe say and that's pain clinic.
This is a pain clinic, doc.
Dr Clayton Dir (33:58):
Right, right well, I mean, like you don't go
to mcdonald's expecting to getsushi right, like what else did?
You expect from a place likethat.
I'm not saying that to you butlike no, you're right, you're
right, keep going with theanalogy you're on and I think
that's why it's important that Ijust shared a post yesterday I
don't even know who it's from.
It said we need more doctors onsocial media, and it talks
(34:18):
about because there's not onlybad information on socials, but
when you actually go into themedical world, that's what you
get like every single time, likeyou can.
Where are you?
Where you guys located at like?
Where was this experience?
At what state?
Therapist Jennifer Schmitz (34:30):
I'm in wisconsin.
Dr Clayton Dir (34:31):
It was here in wisconsin yeah, I'm in kansas
and we have the exact same thing.
Like you know what I mean.
It's.
It's so predictable, um, andexactly what you're going to get
, and so, and what else kills metoo, when you talk about hope
and stuff.
I just shared a post and it gota little bit more traction than
I had anticipated.
Nothing, bonkers.
But I said like here's theadvice I would give as five
years in practice, if I wasn'tafraid of hurting your feelings.
(34:52):
And then the caption said thepain may not be your fault, but
it's your responsibility andyou're the only one that can
change it.
Responsibility, and you're theonly one that can change it.
Therapist Jennifer Schmitz (35:00):
And change requires change.
Yes.
Dr Clayton Dir (35:01):
Yeah, the medical system does such a good
job of saying it's not yourfault, poor you.
You're stuck like this, it'sjust going to happen.
And it's like no, no, like comeinto my clinic, let me look at
things and let me assess you andthen let me show you what you
can do.
Like one of my favorite thingsto do is, as you make someone's
pain, go down, walk out into thegym and say, have you ever
deadlifted before?
(35:21):
And they're like no, doesn'tthat hurt your back?
I'm like well, let's see whathappens.
And I hand them a kettlebell andsay you got a deadlifting 400
pounds.
And I say pick this up and setit down.
They pick it up and they'llhave 50% good form.
Let's say they set it down andI say how much weight do you
think that is 20, 30 pounds,that was 70 pounds.
What Are you serious?
It's like yes, you can deadlift70 pounds, you did it
(35:43):
relatively easy and did you havepain?
And if the answer is no, I'mlike cool, we're going to do
this more to strengthen thesemuscles.
If the answer is yes, then Istart critiquing their form.
And it's also crazy how muchtilt type of thing.
And they're like well, thatdoesn't hurt and that felt a
little bit easier.
It's like do you see howchangeable this is?
And then I then, unfortunately,then it's like okay, now I have
(36:07):
to untie all the shitessentially that this pain
doctor just told this person andpeople don't understand the
weight of that person's opinion,that person's statement right,
when you have a license on thewall and 90 patients in the
waiting room, they think youknow what you're talking about.
And I mean, it's not wrong,they know their stuff.
But it creates such limitingbeliefs in the patient and
(36:29):
that's what pisses me off andthat's what makes me so
frustrated, because it's all ofthat that I have to go and work
and like continuously tell themlike no, like please disregard
what they say.
Like show me your MRI, you know.
Like, show me your x-ray andlet me talk you through what
this actually means.
Cause, degenerative discdisease.
Oh man, so you're saying this isjust going to keep breaking
down?
And then they picture it.
Then they catastrophize it.
(36:50):
Pain gets worse.
They say, oh my gosh, I, I, Ishouldn't move this.
And then there you go into thespiral no-transcript.
Dr Teralyn Sell (37:29):
The lack of hope in, in that idea that you
can't do something is profoundand it eats up the problem.
Yes, it does.
Yes it does, because the thelack of doing something means
her muscles aren't moving andthey're they're.
Basically, you know the musclesare going down and decreasing
(37:50):
and you know.
So now she can't do certainthings that she should have been
able to do before and so, butthat's because the doctors are
telling her you can't.
So if you just blindly listen.
Conversely, there's this womanthat I saw on TikTok I think it
was a while ago and she had andI know this isn't back, but she
had a hip replacement and shewas doing yoga, like a lot of
(38:17):
yoga, and I showed this to mymom because my mom's had knees
and hips and all these things.
She's like the bionic woman,that's what my kid calls her.
But anyway, I said look, I saidI know that you're not going to
be like this woman, but she'shad a lot of things happen to
her too and had a lot ofsurgeries, and she still does
things.
But of course, looking at thatmodel is like I could never do
(38:41):
that and I'm like I, Iunderstand, but you can do
something right and instead ofnothing and I do find this a lot
in the elderly population isthat once they have a surgery,
they become sedentary becausethey're afraid of, you know,
wrecking it, wrecking thesurgery or whatever, because
they've been given the fear fromthe surgeon or from whoever,
(39:04):
that you can't get better oryou're going to hurt yourself
worse.
Dr Clayton Dir (39:07):
Yes, and that's where the hope and the messaging
that we have needs to change,yeah, the narrative that we give
as providers or that theproviders as a whole.
Dr Teralyn Sell (39:18):
Yeah, because Jen and I talk about this all
the time, regaining a sense ofyour personal agency, of like
change.
You are the change agent.
Nobody is going to change thisfor you.
And what message are you goingto start believing about
yourself before you decide toengage in that change?
Are you going to believe thisis hopeless?
Are you going to believe thatyou can do something?
And what?
Dr Clayton Dir (39:38):
what kills me with, like, the two stories that
you can do something, and whatkills me with the two stories
that you guys just told wasabout your parents, right?
Dr Teralyn Sell (39:43):
No, jen, it was not Jen's.
No, we can't out that Huh.
Therapist Jennifer Schmitz (39:51):
Okay .
He already knows.
Dr Clayton Dir (39:54):
Older individuals in our life there
you go, I had a four-year-oldlady in here yesterday who
trains with a personal trainerthree times a week, does water
aerobics two to five times aweek, does Pilates a couple of
times.
And I also treat her and I wassaid first of all I said good
job, by the way, because mostpeople your age they just kind
of quit and you made sure not tostop moving.
I said that's the reason you'restill here.
(40:15):
This girl can still palm thefloor Like she moves really well
.
But her and I kind of went onthis tangent and I said what
pisses me off so much is peopleyour age, I think, are preyed on
significantly.
Because when an 84-year-oldlady comes in and they say they
have knee pain, you are someonewho probably has a decent amount
of money just because youeither have retirements or you
have like social security, youhave something where you've
(40:37):
built up funds over your life,so you probably have money.
You expect to be unhealthybecause you're 84, like yeah,
it's probably wearing down, Iprobably am not healthy,
whatever.
And you're very, veryunfortunately like you just
believe whatever the doctor saysand to none of this is like
that person's fault.
But when you start to see likethis pool of people that you're
(40:57):
like, oh yeah, we could probablyget money on this person pretty
easy.
And you say like, okay, yourknee is wearing down, you
probably just need a total knee.
They say okay, and it's likethat's a multiple thousands, if
not tens of thousands, ofdollars surgery.
And the best part, if you lookat it just from the surgeon
perspective, doesn't matter howlong it lasts.
This person may die in twoyears, completely unrelated,
because you don't have to worryabout longevity.
(41:17):
And then when they get, youknow when they come out of it
they may have some pain.
So now they're going to buythis, and now they're going to
buy this.
And if you know anything aboutsales, the best way to make
money is upselling right like webought this product.
What if we just tack this on?
yeah and next thing, you know,they're two years in and they've
started, you know, threedifferent pharmaceutical
medications.
They're still in pt, they'restill doing this and it's just
like all right, here's thebeginning of the end.
And it just pisses me offbecause when people are in pain
(41:39):
and they go to an ortho, they'relike, okay, we can make the
pain go with surgery.
And it's like 50% of backsurgeries aren't any better at
all.
Dr Teralyn Sell (41:48):
No, and then you find yourself in another
back surgery Exactly After that.
I find that if you have oneback surgery, you're going to
have three more Probably thenext one within two years.
Yeah.
Dr Clayton Dir (41:58):
And it's like cool, this didn't work.
What if we do it?
What if we do it again?
What if we do more of it?
Therapist Jennifer Schmitz (42:02):
Okay , so all right.
So, as as we, as we get nearthe end here, I want to wrap
this into something you wrotefor us before the show.
You, you said you, we need toget better healthcare and that
it's growing.
But as a patient, you need tobe put first.
As the clients, you need tofind a provider that's going to
put you first.
Is this part of the thing thatpeople should be assessing?
(42:25):
When you say put you first, howdoes a patient know if they're
being put first?
Oh, good question.
How do they know that?
Dr Clayton Dir (42:34):
One.
I think it's whether or not theprovider's actually listening.
I'm pretty sure I don'tremember the stat, but I think
it's like 17 seconds before theaverage primary care provider
interrupts them.
The average time spent with apatient in primary care is 2.7
minutes, and so, even if thatperson has a heart of gold, the
provider like.
When you're in a system likethat, it's very hard to stay
(42:57):
positive.
I mean, there's a reason thatour clinic built a system
differently.
I would say that when clientscome in, they fill out their
paperwork.
I usually write up thequestions that I'll have based
on their paperwork, and then Igot this from a continuing ed
course.
They call them asterisk signs,so signs that, like the person
says, I can't do this because ofmy pain, I can't get in and out
(43:17):
of the car, put on my jacket,throw a ball with my kid.
They have something and it'slike cool.
Every time you come in, I willask about this, because it
doesn't matter what I say orwhat I think is getting better.
If you can't feel tangiblechange throughout this process,
then I'm not doing my job.
If you're not getting closer tothe goals you walked in with
and are asking about, then I'mnot putting you first right?
(43:37):
And the thing is is too manytimes I've seen people who go to
the ortho they say look, here'syour knee, let's go and do
surgery.
It's like did we even talkabout this?
Are there other options?
Like, does my opinion matter?
What if I don't want to dosurgery?
What are my options?
And most of the time they justdon't know and so no, this is
the only option, and so that's agood question.
I actually don't know how, likeI don't know a perfect way.
Dr Teralyn Sell (43:59):
I think you did , I think you did and um, I.
I want to just add in thereit's there aren't any other
options that I can do is reallywhat that surgeon is saying,
that I know of Um and so I, butI.
I don't think that that's whatthey say.
They just say there aren't anyother options.
But I wish they would just saythat I know of that I'm capable
(44:21):
of doing.
I wish there was more justtransparency and knowledge and
more I don't know truth.
Dr Clayton Dir (44:30):
Yeah, yeah, just admitting what you don't know
and saying how I help peopleright when you're a hammer.
Everything looks like a nail.
That surgeon is probably goingto suggest surgery.
Therapist Jennifer Schmitz (44:38):
Yes, we've heard that on this show
before A million times.
Dr Teralyn Sell (44:42):
But it's true, it's very true, yeah, so I think
we.
Is there anything else that youwant people to know about the
power of PT that they might notknow?
Dr Clayton Dir (44:56):
I would say, your perceptions of PT.
If they're poor, it's probablya bad PT, not a bad profession,
and you need to find someonewho's going to like sit with you
and help you, Just like.
As I know, the conversationaround therapy in regards to
like mental therapy is if youdon't vibe with the person, go
find someone you vibe with.
I mean, that's the end of it.
And unfortunately, healthcarechange can only come at the pace
that people demand it, and soif you're not going to support a
(45:19):
provider like me or providerslike you guys, then you guys
can't grow.
And so it's kind of like, ifyou're going to advocate for
better healthcare, you have toput your dollars there, you have
to show up in those people'soffices, and someone like myself
I don't use any healthcaredollars Like I go once a year to
make sure like my blood's not,you know, horrible or something,
and so I don't I don't evenhave power to do it, cause like
(45:39):
I don't need much right now.
But when you go sit with thesepeople that you're, you guys are
talking about in those offices,like don't give them your money
, like don't go to that office,like take your bad experience
and give that person a badreview appropriately.
I'm not saying like destroythem, but like make sure that
you're incentivizing the goodproviders to keep doing what
they're doing.
Help those providers provide sothat the dollars can start
(46:02):
coming out of the crappy systemand start building up the better
system.
That's what I'm looking for andthat's what this podcast is
probably all about as well.
Dr Teralyn Sell (46:09):
Yes, I love that idea.
That is a fantastic way to putit, because I agree with that
100%.
And, by the way, most of myhealthcare dollars don't go to
the system either.
Therapist Jennifer Schmitz (46:20):
I know I'm having an issue because
I keep firing all my doctors.
So, I'm running, I'm like, yep,we're out of that realm now
because, I fired pretty mucheverybody so, and that's good.
Ok, like people fire me too,I'm like hey right, all right.
Shop around Like for sure.
Oh, all right.
Well, we've reached the end ofthe show.
Everybody, dr Clayton Durrrhymes with gurr.
(46:42):
Thank you for being on the show, clayton.
It's been great to have you.
Dr Clayton Dir (46:46):
Thank you so much for having me.
This was a blast.
We should do it all the time,every week.
We'll do it every week.
If you need a tri-co-host, letme know.
Therapist Jennifer Schmitz (46:54):
Oh sure you guys.
You are listening to the GaslitTruth Podcast.
You can find us anywhere thatyou listen to podcasts.
Please make sure that you giveus a rating only five stars.
We had someone who gave us fourstars very recently and told us
it's because we talk too much.
So guess what?
Don't listen to the show andyou can find us on any of the
social medias.
And if you want to send us yourGaslit Truth stories, please do
(47:16):
so at thegaslittruthpodcast atg.
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