"True" Strength Training For Surgical Recovery With Client, Jacob || WBWL EP108

What is “True” strength training especially in physical therapy.

My client, Jacob, described previous experiences with other PT’s as easy and still had ongoing pain and disability.

His hip that he had surgery on twice still wasn’t better. Getting back to day to day hiking, running, weight training, and merely sitting at work were all still painful.

Jacob talks about how having a concerted plan in the gym, progressing overload, and being treated like an athlete was the key to his pain-free success.

Yes, surgery you must allow things to heal and there is some temporary inflammation. But the human body (and mind) are resilient as such, we need to treat our clients in the same manner.

I’m happy to say that Jacob his weight training lifting 200+ lbs even after 2 surgeries, and he now has tools to carry forward on his own.

If interested, apply for 1:1 coaching in my bio or description.

To your best life,

Dr. Jay

Transcript

0:02

All right. Welcome in guys to another episode. I'm Dr. Jason Won, orthopedic physical therapist. And today I have one of my clients here Jacob Jacob, me and him met in the Bay Area. And I think he was referred here by another client that I was working with. And it's been a really, truly a privilege to see him grow see his progress and transform. And I think that he'll be probably the best person to speak about some of the things that he's. He was struggling with some of the things that he's tried and ultimately what was some of the main factors that actually led him. Two success. And I think some of the things that he hit on that he wanted to really speak about was one, about consistency and two about progressive overload. So if if you don't know what those things are, consistency is something that you know, but if progressive overload is something that you wanna learn more about, something that can help you to transform your health improve your pain levels stick around.'cause we have a lot to uncover. Jacob I genuinely appreciate you being here. So how are you doing, man? I'm doing well. Doing well. Appreciate you having me on. Yes. Thank you so much. So yeah, Jacob, why don't we first talk about, just, a little bit about your background so who you are, what you do, and what are some of the things and what are some of the health related things that you were struggling with when we first started. Yeah, for sure. Yeah, so I'm 27 years old, work as an urban planner. And I came to Jay I guess about six to eight months ago at this point. But I'd, I've had two kind of hip arthroscopic surgeries that are fixed labral repairs. The first was about five years ago and the second was about three years ago. And they both led to some improvements, but the rehab never got me back to where I wanted to be in terms of fully active biking, running, hiking, doing the things I love to do. And it led to a lot of kind of compensatory in injuries, in terms of back pain and knee pain, even foot pain. And so I realized that kind of, I just had never gotten past the point of clamshells and my PT exercises. I needed to learn how to really take care of my body and strengthen my body, and came to Jay. A friend recommended him who had a really good experience and thought it would be a good way to, to get me back on the right track. Awesome. Yeah. So that's a great background. So with the arthroscopic hip surgeries that you had what were some of these specific, like movements limitations that you were having? Or was it more like just, a lot of times there's like more sedentary base, so like sometimes prolonged sitting. So yeah. Just explain some of the more triggering factors that were hindering you. Yeah. So yeah, before those surgeries, it was sitting for more than. An hour got to the point of being really uncomfortable, any kind of impact. So things like running, jumping were really uncomfortable. But then even after the surgery the rotation of the hip, so internal external rotation really were limited. And then I think I just learned how to really protect that part of my body, but didn't really. Feel comfortable working through the pain. And I think that was a key part of our work together in terms of learning how to push through under understand that some pain is okay, and then learn how to push through that in order to regain some of that mobility and flexibility that I had lost for a number of years. Yeah, for sure. What were. So with regards to physical therapy and some other treatments, so obviously two, two surgeries with regards to like the rehab, whether it was prehab or even like post, post-surgery how was your overall experience there and do you mind sharing about just Yeah, some of the interventions, what kind of stuck with you? What, why do you feel like maybe some of it didn't work for you specifically? Yeah. So I'd always heard like surgery should be your last resort, and so before the Sur first surgery, I. I thought I tried everything. I did at least a year of pt. I did a lot of dry needling. I did acupuncture, I did cupping, I did massage. I, I did, I think everything I could get my hands on. But I think the piece I probably didn't hit was like true strength training. And that just didn't feel like it was something out there from the PTs I was seeing. And so it was really much more focused on banded resistance, which is useful. I think never allowed me to build up the necessary strength and the muscles that had weakened over time. And yeah, I think with the second surgery I probably moved a little bit more quickly. I probably didn't even exhaust all my options. I did again, did pt, did the dry needling, but was okay, this kind of worked the first time. Let me try it again. But I don't know. Yeah, surgery is expensive. The recovery is grueling and I think I'm an example that. I am better, but I'm not as much better as I think the surgeon's promised. Yeah if I were to do it again, I probably would've tried a little bit harder, especially with the second hip. Yeah. Sur surgery and injections are. All different types of interventions. I wouldn't even deem them whether it was like, positive, negative. I think most parts of healthcare are trying to leave a positive outcome on their client's lives. Otherwise why would they be in the profession? But at the same time, I think some don't really set really strong expectations on, again, what we talked about is like consistency and progressive overload and strength training. I think that consistency. Trumps everything. I think I've said that on multiple podcasts already. How I think that consistency amongst the many aspects of exercise and the things that you can learn in physical therapy, the most important is consistency, which is something I feel like I hit on really hard from the get go with you. Even before we even started working together. It's if you're not consistent, we might as well not even start, but if you're gonna be consistent and you're willing to learn the things that. I can teach you consistency will win over everything, which hopefully since obviously we're no longer working together, but you're here, is that you're still maintain that level of consistency. Progressive overload really critical because there's much more merit and there's a lot more value and significance to overloading the tissues that accompany your hip. And some of the areas that we were able to resolve together, if you're not really working those tissues around the joints, biologically speaking, you can do as much of the passive manual treatments out there that are gonna give you some, some temporary relief. But if you're not using that as a window of opportunity to load your body up more, then you're really not gonna get back to your functional goals. So that's why I always say that doing passive treatments is not gonna lead to active goals, right? You have to pair up passive with active. So with all that said, do you feel that, just going back to your experience with physical therapy, do you feel that you were absolutely consistent at that, at those times and do, or do you feel that because you weren't really seeing the results with the banded, let's say clamshells and all those things that I said that I rarely promote them, especially for a 27-year-old athlete? Do you feel like it was consistency was a factor or do you feel like it was more just the kinda the treatments that were given to you? Yeah, I think I was reasonably consistent with it, but at the end of the day, I just never really saw that much improvement. And I think it was I don't know if this is an analogy you gave me or heard from someone else, but like you're on this hamster wheel. If you're just like going around and around, you get a little bit more, but you're never able to talk to get off the hamster wheel of being independent and on your own. Yeah, I think it was okay, I'm gonna go two times a week and I'm gonna do my exercises and I'll do them twice at home. But it's like at the end of the day, it's not getting me, I. To where I wanna be, and it's more like I'm checking a box so that I can then go get surgery, which is how it felt like. The surgeons talked to me and treated me. I was like, okay, this is the only solution. And then if you're gonna go this path to make sure you meet the insurance requirements, we're gonna have to do. Pt, you have to check this box, you're gonna get your injection. But the goal isn't really seeing if you can avoid surgery. It's more just these are the prerequisites you can get surgery and yeah, someone that didn't. I think at this point I'm much more knowledgeable about the healthcare industry and, but when I was 22 and this first happened, I was like, okay, like a doctor with an MD is telling me this is the way to go. I guess this is what I have to do. And then the surgery's gonna get it better. And then get me out of this hole that I'm in. Yeah, no, it was alarming, to be fresh outta college and having to go through this, but, yeah, that was my experience. Yeah. And it's totally fine. What's I guess what's done is done and it's part of your journey that you've been on, and I'm glad that you're much better as a result of it. Surgery is. It's not a panacea for everyone. Surgery are gonna have various outcomes for people, and also it depends on, your mindset as well. So EE regardless of the surgery, nobody should think that they're damaged goods, leading into surgery. I also think that surgery is ist is a product of your beliefs. So if you do feel that it's really going to genuinely help you, then a lot of times that can spring you into the actions necessary to get past that surgery. A lot of times if you're going into surgery with with either negligence or I guess thinking that it's going to may maybe even go into a thing like, I think it's gonna help me, but you're coming into it with a little bit of doubt and uncertainty and skepticism then actually that might actually lead you to a negative outcome. So now that you've, now that you've had obvi obviously have been through that do you feel before we dive into like our treatments and what we've done, which I think is gonna be super valuable for people. Did you have any expectations going into the surgery? Was there any fears, uncertainties, doubts pre or post-surgery? I'm just curious in your end'cause mindset and your emotions, that, that plays a lot into the overall experience of, in your health journey too. Totally. No, and I totally agree with what you just said of like you have to, before you go into surgery, you have to be a hundred percent in.'cause it's a traumatic event. You're putting your body through and you have to be, you have to do all your prehab and then you have to be fully committed to the rehab. And so I think with both cases I was I was committed to, especially after the first one, I knew what I was getting into myself with the second one and kind of prepared accordingly and prepared with my job and got my PTs in order. And yeah, I think the rehab I, I. Just didn't love my physical therapist the second time around as much as I did my first time. And I think that's such a big part of it. I think the surgeon's key, but I think the physical therapy is probably equally if not more important. And so yeah, I think if that was one kind of thing that was just like a stressor. I just didn't, we didn't get along as well. And I didn't feel like I had the level of trust that I had. And I think that's such a big key. Part is you really need to feel like they understand what you're going through. And, but yeah, I think as long as you're mentally committed to mentally aware of what you're gonna be going through, I think that's such a key part that surgeons don't really talk to you about is like the mental distress of that event. And that's just something, it's like a learned experience. I don't know how else to to speak about it. It's all right. You talked about trust and, that's a huge piece. I think the two words that come to mind when I work with any client is trust as well as a therapeutic alliance. The alliance is the fact that if you feel like my goals are not aligned with your goals, then you know you're not going to trust me. And that's why I always do a consultation to, to see if we're a good fit, at the same time, really understand that if your goals don't mesh with mine or if your expectations are. Either underwhelming or far beyond what I can give to you, then I would say I, I wouldn't even start working with you. But do you so with regards to how we were able to interact and do things, did you find that as even from the first session, did you find that there was a level of either accountability, trust, communication did you feel like a lot of those were hitting the mark, or was it as we kept going, then you started to gain that trust? Because I know that. Tr you know you going through many things. There's some, somehow there's, there's walls, right? There's sometimes mental walls of trusting people. I'm just curious on your end about when we first started how you felt. Yeah, I think I remember from our first, so we had an online consultation just like a call, and I think the first thing I remember is just feeling like you almost like a sense of just like empathy from you and that you. I don't remember. I know you've also gone through plenty of injuries yourself, but either from those personally or just from all of your work, it felt like you, it felt like we were speaking the same language, which is a bigger deal to me than it might sound. But I think just having had these experiences over the past few years, it's like being able to really just feel understood, felt really important right away. But yeah, I would definitely say it takes time to build trust and actually get a. Starting to work out and get in the gym together. But I think that was the first sign that was like, okay, this is something that could work.'cause it just feels like you actually understand what I'm saying to you. Yeah. Which is really important to me to start. Yeah. Yeah. Yeah. I think one, one point of like where I really felt that I could help you was the fact that when you said you had the two s was like, oh yeah. Just literally a few months ago I was working with somebody with the same exact hip. The same exact surgeries, and he had two as well. And he, and I was like, dude, if a 40 something year old dad who has many obligations and he's older, can make huge differences. I'm like, you're 20, you're 26, 20 7-year-old. I'm like, you're probably gonna to do better if anything. So I think that was that was a huge point that gave me a lot of confidence. But I think also, yeah, I didn't instill confidence in you. Yeah. Let's hit on the. Let's hit on the stuff that you learned, obviously. I think that's really important. So the education even from the first session, what were some of the key takeaways? I know it's a while back, but what were some of the key takeaways right from the first session that you felt like you really learned the most? So just talk about, even just in general your first session and how that kind of went. Yeah. Yeah. So I came to you with kind of these fears that like my body felt like it was broken, right? I just moved to the Bay Area from Colorado maybe two months before, and yeah, from the move or whatever it was my back was in a bad spot. I had this kind of plantar fasciitis pain. The hips were problem. And I think the first thing that we really talked about was just like, you need to learn how to load your body with weight. And yeah, I know that we, we keep getting back to just this resistance training, but learning how to your tissues and your kind of tendons need to learn how to really handle weight if you're gonna get serious about doing big backpacking trips, if you're gonna go skiing again, if you're gonna learn how to play sports again. And I think that was the biggest thing. And it applies to everything. And I think about it every time I'm in the gym now, it's like you need to think about. Progressively increasing the weight that you're putting your body under and do it slowly'cause you're gonna get hurt otherwise. And I think, yeah, we had setbacks in our time working together, but I think that was the biggest thing that I learned right away that's really stayed with me is just learning how to put your body under weight so it can adapt to real life kind of circumstances really well. Yeah the big words are like capacity. So just you understand that like when we first started capacity, just a I think like a Duracell battery, a capacity is it has a specific amount and that at some point if you try to surpass that capacity you blow up the battery or you have setbacks and flareups. And that was a huge piece too is understanding. And maybe we didn't set that expectation, but I was like, Hey, there's so many clients that I work with where. If they make a mistake in their training it's not the fault of the exercise, but it's the fault of the person that either overloaded that themselves too quickly, right? So like too much, too soon if you will. And sometimes when you have those setbacks sure there could be doubts and uncertainties, but at the same time I'm always like, you gotta learn from your mistakes. I am not somebody that has the perfect. Even for me, after doing this for 10 years, working out over 18 years, I still make mistakes in the gym and I still will flare up things, but at the same time, it's like that is literally a part of learning. You, everyone makes mistakes with their relationships, mistakes with their finances, and in the same light, Jacob, as is that you probably have left our last session. Probably have hit some hurdles, right? Have had some inklings of discomfort, but at the same time it's like you've built up your capacity so much so that compared to first session, you're tolerating 200 plus pounds with either deadlifts or squats. And obviously that's a much better place to be, right? It's just being empowered that even despite pain, you can easily get past it with the right strategies, consistency. What is it? We don't have to define that, but why was that so important during our time working together? Yeah, I think, what I've learned is it's just that that's the only way you're gonna see any progress, right? With these rehab, the rehab and the rehab it's hard to be consistent.'cause after one session you're not gonna see any improvement. And I think mentally it's hard to trust that. You're gonna get anywhere because it takes time and I think really learning to be patient with your body. And for me, I'd just gone through so many years and so many different specialists and treatments that it was hard to like trust. But I think that goes back to how we started with the beginning. It's just like trusting that this is the process you need to commit to and. If you're consistent, you're gonna see improvements and like they will come. And it took time, right? I think after my first week, no, I didn't see anything after the first two weeks. I didn't see anything. But it's like trusting that things will improve and I could feel myself getting stronger and I could feel my back, getting more mobile and open, opening up for the first time. And yeah, and like over time you do see the results you really want, for me it was being able to get on my bike and riding it for two hours. In a way I hadn't done in literally years. And that was the biggest part of my life before the surgeries. And so I think that's you will see markers that really mark the progress, but I think just like trusting that you really need to be consistent was the biggest thing for me. And yeah, I think that was like, I mean with your, I think one, like we had, we obviously had the session showing up, but you were incredible about checking in and Hey. I saw that you were at the gym today, let me know how it went. And I think that's the accountability that, that really came with the treatment that kind of enabled the consistency to happen. And that you have a little, you have another layer outside of just yourself because it can be hard, you have your job, you have all your other responsibilities, but to have someone else, in your messages a few times a week being like, how did the treatment goes is really made a difference I think, for me. Yeah. I was gonna ask you that follow up question, and the question I was gonna ask was like, what. What enabled you to build that trust? Because some, so many people can go through one session. One, I always say that the first session for, from my end, from my perspective, is really critical.'cause if, for example let's say on the first session I gave you the wrong treatment or the wrong exercises and you just flared yourself up and you're lying in bed, like what makes you think you would want to come back to the second SE session, right? You'd be asking for a refund, but, the that and that, that's actually true. That's what I think about is like really gaining the trust right from the get go. So besides, I guess the ongoing communication, or maybe like when I saw you log a workout, maybe I congratulated you or say Hey, let's keep it going. Anything outside of that accountability that really enabled you to build that trust from the first and second session, and I asked that because. It is really critical for sometimes to build that alliance right from the get go. Outside of those check-ins, was there anything else that kind of allowed you to build that trust? Yeah I think the communication was probably the most important piece. And then outside of that, yeah, I think just starting to see the progress enabled me to to build it and yeah I think that you take a slight leap of faith right in, in committing to the training and. I think for me it is if I'm financially committing to this, I really want to take it seriously and make sure I'm being consistent to see results. And so I think that was a part for me is I'm investing my own money in this. I want to like and it's, I wanna make sure there's a clear kind of line to how I'm doing and I think that helped me take it even more seriously. Versus if I'm like going to PT all the time, I'm investing probably more money in PT than we did in our training. But there's like less of a, there, just, there isn't the accountability in PT that I feel like we had together, which is I think, the most important piece for me. Got it. Yeah. The be besides me keeping accountable, was there any differences as far as the type of program that I did set for you? I try to I try my best to pride myself in building very, like more robust or very contextual type of exercises. I have a platform and app that. I feel, gives people a good sense of like video demonstrations, putting stuff on the calendar. Or maybe, I know you're pretty techie yourself, so putting it into your own Google or Apple calendar. So yeah. What's the experience of just having is not really I'm not asking you to rate the app, but in terms of like the way that I set things up and the way that you were able to follow through with it. Was there any value to that compared to maybe other PTs? Yeah, you, I don't, you, you asked not to rate the app, but I would say I love the app. I think the app made it incredibly easy for me to follow along. There were a lot of times, not a lot of times, but there were a few times where the gym I go to didn't have the equipment that I needed. And so in those cases, like to be like, Hey, try this instead. But at the same time, the app also has a lot of different suggestions for Hey, you wanna hit your adductors and you don't have. The adductor machine Hey, try this instead. And so I think the app made it incredibly easy. It sends me pings when I should be working out. It allows me to just like really hold myself accountable. And I think it obviously communicates with you two, so you're able to track the progress. No I don't know. I think that's a phenomenal tool that you have and it allows you to really in real time update workouts and I think it allows us to communicate very easily with each other too. Besides the app, which that is a part of the consistency.'cause I always feel like, what if it's in your schedule there's a saying I think by like Steven Covey, it's like either schedule your priorities or prioritize your schedule. So that means that if you schedule your priorities and like you schedule in these workouts they will happen. But if you prioritize your. Super busy times strapped schedule who isn't times strapped nowadays, but if you prioritize that, then you're prioritizing everything else besides the fitness, right? You're prioritizing the the chores the dates or even your job or other means. So what I. With regards to the consistency outside of the app, was there any other strategies or things that you employed, even just to make like mobility a habit or when you're at work was there anything that you specifically employed or things that I taught you which I know it's been a while, but sure. How were you able to stay brutally consistent even outside the app? Was there any strategies that you employed? Yeah, I think for me, just like when we started working together, I was like, this is. I thought I took my recovery and training seriously, but I like realized in retrospect, I just didn't. And so it's okay, we're gonna be in the gym. I think you had me in there kind of four times, probably a week, and that was the split that we worked out. But it was kinda like, you need to be doing these other things at least two to three times a day. And I'm like, oh, come on. That's crazy. Like you want me foam rolling my back all the time? You want me doing all these like hip openers and things like that, but it's yeah, you do. Like I'm sitting in this chair seven hours a day at my desk working. And it's okay, if you're gonna be serious about that, getting on a bike where you're in the same hunched position, you have to treat your body better. And I think that just like something finally clicked for me and that okay I'm not old, but like my body will break down if you don't start treating it better. And I think that message just takes a long time for someone still in their twenties to sink in. But I think I've just had enough repeated experiences that like you have to. Be consistent and I think the mobility is key of just these 10 minute workouts that you do two or three times a day to just keep your back, keep your legs, keep them like looser and more opened up. And I think again, it's like over time you will see the progress and see the results. And I think that's the easiest way to be consistent with this. Because if you don't see progress, it's hard to keep wanting to do things. But I think just being consistent that first month and getting, I think us from the first to the second. Session and already being able to I think, trust the process we were on allowed me to really buy in from there. Now that I think about it, I do recall like the first and second session I wouldn't say there was pushback, but there is a, there's always a sense of me like trying to lead by example. So when I told you, Hey, like this is what I do, and then you're like, okay, let me see what you do. I was like let me show you my formal routine, but I told you like, I do this eight to 10 times a day. And you're is that you mean necessary? I'm like if I don't want my body to break down. That's the necessary preventative things that I do. And it's really up to you if you wanna follow suit, right? And I'm like, you are younger by a good 8, 7, 8 years. But if I'm really consistent at my age, it's if you want to be either where I'm at or if you want to maintain your body as you get older, like you wanna, I. Maybe create these habits as you're younger, right? Speaking to people in their twenties, it's oh, twenties. There are a lot of people, even your age are like, oh yeah, I can get away with certain things, right? And I'm like, no. If you set the right habits now, you would set yourself for success into your thirties, forties, and fifties, right? Oh, I'm really glad that you're like, even outside the gym if you're gonna be sitting on your ass for eight to 10 hours, it's like you can afford. 20 or 30 minutes of mobility at work. And if you don't, then you know, then you're, you are working backwards essentially. You work. For every hour that you sit, it's probably can get stiff again. So you need to supply it with something that will allow you to get out of those stiff points. Otherwise, that's where people can incur more arthritic changes or the joints can get stiff. And then, if you think that you can just make it all up at the, at nighttime or make it up on the weekends, that is how literally people get injured is thinking that 40, 50 hours of sitting your body's gonna be completely okay by the weekend. So I'm glad that you. Hopefully even today, you're still hitting on those same points, right? You maybe had the foam roll or something close by to your desk. Yeah. Yeah. That's good. It's good to hear. All right, let's hit on progressive overload. I guess you, you can teach me back, so what exactly is progressive overload and how were you able to employ that, throughout our time working together? Yeah, I didn't know if we were gonna do a little pop quiz. Let's hear you de No, for me, progressive overload is learning how to add weight onto your muscles gradually through your training up until the point of kind of failure. And so building up slowly and then pulling back a little bit. And inherently doing that kind of progressively gradually over time. And yeah, I think we applied that to everything in the training. Obviously, I. Everything kind of that I was hitting in the gym, so squats, dead lifts, everything like that. Just making sure that I was building up my weight over time. And I think the really important thing, we've touched on consistency, but I think the tracking was really important too, and something I'd never done previously. Before. And so making sure I'm being really good about how many sets, how many reps and really drill down to how much weight I'm doing.'cause I think that's the only way to really see my progress over time. Previously in the gym, I would just go in and say, okay, I think I've had 30 fives last time. Let me do this again. But actually tracking and seeing my progress, I think I was able to get stronger a lot more quickly because I was actually being intentional about what I was doing in there. Yeah. I always compare this to finances. So if you're not tracking your finances, then you don't know what money's coming in, what money's coming out, and then you're, you end up in a negative cash flow. You ne you end up in debt or you get, you, you're, or you get in trouble with IRS. And in the same light with finances is fitness is just as important. Fitness in terms of if you're not seeing what you did the week before, then what makes you think that you're going to progress the week after? You gotta progress something, whether it's volume, which is holding your plank longer, or it's adding on a couple extra reps every time. It's just going into the gym, understanding that you need to become 1% better. And another point we hit on was. Understanding what failure feels like. I think there's a lot of nuance in this industry around do you need a hit failure? Is failure even important? Do you need a feel soreness the next day? And my take with you for sure, Jake was like, if you want to, you have all these athletic endeavors. Not pushing to contractile failure is a mistake. Going into the gym, just thinking you can half as it, that's a mistake. Not logging workouts and not logging workouts for the rest of your life. I really think that's a mistake that I think 90% of gym goers or people that even go to the gym, they make that mistake. I think I showed you my data. I'm like, I have data from 10 years ago and that allows me to make justifiable decisions on what I need to be doing in the gym today. With. With in, in terms of that, I know that the app really helped as well being able to see what you did from week to week. So with regards to, in relation to the progressive overload, what changes were you seeing as far as like how you felt on the day-to-day and also getting even back to the activities that you wanted to do? How did progressive overload translate into that? Yeah, I think the fir, the first week I really remember being like, I think we had two leg days that first week. And I was like, I can't get up and down the stairs. And it's I'd never trained really legs consistently in my life and we're like, okay, no. That's good. You have to really push. I think learning how to push through the initial soreness was the mental hurdle, mental block I get through. Yeah. But I think that was really, that was a big deal I think right at the start was getting through that. But then from there it's yeah, learning how to understand what kind of soreness is good for your body versus if there's anything that kind of, you're like, okay, this is something that like, Hey, let's check in. This doesn't feel right. My knee is doing something that it shouldn't be doing. But yeah, I think like learning how to push yourself a little bit harder each day, but then also really learn how to recover well. We really talked a lot about the nutrition, making sure kind of, you're getting enough. Hydration, sleep, protein, those things so that your body, is staying sore to recover, but not staying stored longer than it really should be. So I think that's also a piece. I know we didn't focus too much on nutrition. But I think just like getting that information really dialed in, making sure I was hitting these marks of how much just like the right kinds of food I need to be getting into my body and really sleep I think is something I probably prioritize more than I had previously as well. Yeah, I know we didn't hit on nutrition a lot, but obviously you have my contact, so we'll have future conversations about that and we'll definitely keep in touch. The points of consistency of progressive overload are the ones that we hit on the most, just'cause I felt like that was needed in order for you to maybe overcome either your fears and uncertainties with your body in the future. And also just making sure that you have a plan of attack where. You can continue things on long term. So maybe that's just one thing I want to hit on for some people that are listening to this is I guess there are certain practitioners that wanna fixate you to the treatment. I think it's a part of the business model at times. Like when you start your own practice, it's like, how can I, how can I keep, how can I keep the client, in, in my care? But I told you from the get go that I didn't want to teach you, I. Everything that I know so that you can continue this on long term on your own. What is your thoughts about the word autonomy and independence? Do you feel like that's something that you gained during our time working together? A hundred, like a thousand percent. I think the thing that's been bouncing in my head is we've been talking is I think the mental health component is probably one of the pieces that's been most improved through our time working together. And I think that directly. Is attributable to the independence and autonomy that I've gained, right? Like my body is still not perfect. I think it's gonna be a process for the rest of my life. There are days where I'm like, I am in pain again, I'm like having a little bit of a mental breakdown and what's going on, but I remember now that it's okay, you have to do your mobility, get back in the gym and be consistent about what you have to do. And that's done more for me than all these other practitioners that I've seen, including the surgeries that I've done over time. And yeah, I think there's like just a direct connection between feeling like, okay, I'm actually the owner of this body even though it's not perfect. I'm the owner of it and I'm in charge of being able to get it better. And that's, I don't know if that's like the, that's probably the best testimonial I can give you because I think that's something that, that it can't be given. It's something that you really have to like beat. You have to learn it on your own and experience it through the consistency. But being able to feel that way in your own body again is something I'd lost as a result of these surgeries. And even though I'm not perfect again and I'm still, it's a work in progress. I'm so grateful to have that piece back. Yeah. There's a quote that I use which like, perfect inaction, it's. Like per perfect in action is never going to supersede like imperfect action. So like you, you saying that your body's not perfect. I'm glad that you're admitting that. I'm glad that you still can admit to people that are listening to this, that despite the successes that you've seen mentally, physically, from a mental standpoint, no longer in a state of fear. Physically much stronger than you were before. I think where we left off is you're, or you're lifting like 200 plus pounds off the floor. I'm just or it's something close to that. It's very obviously very emotional for me to see my client's growth going from a place of like, where they're doing band and clamshells. So like now they're lifting 200 pounds off the floor. But I'm just very glad to see that like you are telling people and admitting that things are not perfect nowadays. Like I still will have days where maybe I mess up. Maybe it's, I'm more stressed. Maybe I skipped a workout or two, and my body's not feeling good, he is not feeling the best today. So I know I need to just level up my consistency more or level up my knowledge more, or just get back in the gym, right? So many things. My, my baby right now one baby she's just learning to walk and she's going through this like huge milestone of her brains changing and you can tell she's waking up. Three times. I, she just woke up three times this night, and so my sleep is shot. And I don't know if people can see the bags in my eyes, but there there's things that are going to hit you in the face. Things that you sometimes are, you're not prepared for, and sometimes you gotta just, I. Either one, level up your consistency. Understand that things aren't perfect. And I know you're not a parent, Jacob, you'll go through your own inconsistencies. And anybody that comes into this expecting that things are to be absolutely perfect is I think they're saying themselves up for failure, but to now say that you are at a place mentally, physically, where you feel like you're in control again, what are maybe some things that. You're looking to achieve health wise in the next six to eight months, whether that's like an actual concrete goal or whether that's just you just working on the process of just becoming better or more consistent. What are some of the things that you're thinking about right now? Yeah, no, I've thought about this question and I think for me it's more just like living pain free for hopefully the rest of my life. Maybe that's not realistic but living pain-free in the short, medium, and hopefully longer term. It's I think I used to be someone that's like always onto the next big thing. I want, what's the next mountain I want to go trek up to? I want to do another century on my bike ride. I wanna do X, Y, Z. And I think right now I'm in a spot where I'm just mentally Hey, be really grateful. I. For kind of practice, a little bit more gratitude for your body. Be really grateful that you're getting through the day in less pain than you used to be. And yeah, get out on your bike, enjoy the summer, do travel, get out there and do all these different things. But I think right now I'm really content to just be practicing gratitude for feeling good in my body for the first time in, in a lot of years. And yeah, I think the challenges, the what will come, I think. I'll wanna get back on my bike and do some crazy rides maybe next year or maybe later this summer. But yeah, truthfully, like right now, I'm just happy to feel really good in my body again. I'm very grateful for that. And practicing gratitude. It's probably another theme, another podcast episode. Have episodes about gratitude, about just the role of it actually modifies your DNA. Starting off the day with gratitude is not just like a mental uplift. It's not just that. It's not just like people saying, oh yeah, be positive. There are actual physiological changes to actually practicing gratitude secretion of oxytocin keeping your body away from cell apoptosis, which like cell death. I'm glad that you're doing that, Jacob, because practicing gratitude and starting your day off with gratitude, there are true physiological changes that, that change your actions, that change how your brain is working that day. So just very. Thankful that you were able to hit on that note, just being grateful that your body is serving you well and that if you were putting in the work, taking the failure, being 1% better daily, again, more concrete things like tracking workouts and being brutally consistent and even working on that consistently long term, that's gonna pay a huge dividends in the long run. So I'm glad that. Autonomy and independence and some of my crazy addictions for fitness have rubbed off in you to some degree. And with that being said I don't know if there's if you feel like there's any sort of like last kind of like messages for anybody that's listening, whether they've tried a lot of things or whether consistency has been a factor in their life what are maybe just like one or two things that you can hit on if you were teaching somebody. Over the past six to eight months of like stuff that you've learned, what would be some things that you would teach to that person? Yeah. I think the first, and yeah, we've talked about this, but I think the first is just like the mindset shift of making sure that you're the one in charge of getting yourself better. I think that's something that, that you always focused on is like, Hey, I'm here. I'm gonna, I'm gonna teach you what you need to know. But at the end of the day, it's your life, it's your body, and you're the one that has to really be owning this process and owning kind of it for the rest of your life. And that's not something that had ever been, passed into me from other kind of physical therapists and okay, you're gonna come in here, you're gonna do these things, and then do'em, do this, do the same thing at home, and then we'll come in the next time and we'll do it again together. But I think actually. Being like, Hey you're the one doing these workouts on your own. I'm gonna help you. But getting that ownership and I think that's the mindset shift that shifted into kind of improving my mental health as well is okay, like this process is yours to control, I think was the biggest thing for me. But again, is like you're there along the way and I, yeah. I don't want people listening to this to be like, okay, I'm gonna be in the gym solo, and, but. I don't know if I'm squatting right? I don't know if I'm deadlifting right. I'm gonna hurt my back. I don't know what I'm, I don't really know what I'm doing, but like you were there along the way, I could send you videos, I could send you a voice memo, I could send you whatever I needed too. Excuse me, to get my message across and make sure that kind of, you're there to really assist me in the process. And I think to this day, if I sent you something, I know you'd respond. Within a few minutes or a few hours. I know you got two young kids, but I think that the accountability there and just your reliability was really important to me throughout and feeling like you were there to help me through the process. Yeah. And yeah, as, as much as I have two young kids, I always consider my clients like. I always say my kids and my family come first. My clients are pretty damn close. Second in terms of the care that I'm trying to provide. And yeah, again, we hit on autonomy, consistency, progressive overload. And I know that those things are like, as long as you teach those things pretty well and you say to yourself, yeah, that you're in control. Then I know that I'm pretty confident that uj can. Carry this on long term. And also, share the message obviously,'cause there's so many people in the world. I think even in healthcare where consistency is not something that most healthcare practitioners hit on hard enough. Nor even the progressive loading aspects. I know that there's a concrete Hey Jacob, this is how your hip works. Hey your spine's doing this. Hey, your scapula is. It moves in these positions so you can move it. I think those are all great, like tactical things that I've taught you Hey, this exercise can help reduce your hip pain immediately. Oh, cool, cool. That's cool. At the end of the day consistency, autonomy, independence is probably the most important. I know I showed you what, like 40, 50 exercises during our time working together, but. I could have shown you five. And as long as I can, as long as you're breeding consistency, that would've been fine enough for me. But obviously, you paid more for just more strategies on that end too. So any case, yeah. Jacob, I just wanna thank you again. I'm grateful for our time we're together, our, the relationship that we built. I know that you're gonna obviously continue to. Push far beyond our time working together. You're not just settling for the stuff that we had, you have some loftier goals. For anybody else that's out there that may be struggling with pain look at Jake and look at other people that have proven themselves. That they were able to get past their pains and get past certain mental and physical hurdle. So Jacob, thank you so much for being here again, and I know we'll keep in touch from here. Absolutely. Thanks so much for having me. All right, Jacob.