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- Welcome my friends, to the "Bob and Brad" podcast.
My name is Mike Kenitz, and I'm a PT assistant.
Today I am interviewing Rick Olderman,
who is a physical therapist, and we are discussing
his new book, which is coming out early next year in 2023,
and it is called "Solving the Pain Puzzle,
Cases from 25 Years as a Physical Therapist".
So without further ado, here is Rick.
All right, welcome back to the show, Rick.
- Thanks, good to be here, Mike.
Thanks.
- Today we're gonna be talking about your new book,
which is called "Solving the Pain Puzzle,
Cases from 25 Years as a Physical Therapist".
Here is a picture of it for our audience watching.
It's not out yet though, is it?
- No.
They can pre-order it if they want,
and I have a link on my website.
And maybe there'll be a link in the show notes here too.
- When is it coming out?
- I think it's coming out early 2023.
- Okay.
Could you tell us what this book is about?
- Sure.
So I wrote this other series of books
called the "Fixing You" series back
about 10 or 12 years ago, and over the years,
many people have commented that,
and well, let me back up a little bit.
In that series, I feature the anatomy and physiology
of why we're having pain and what's going wrong.
And then I have these client connection stories
that are usually a paragraph or maybe two
that kind of illustrate in a person
how these principles worked in this particular patient.
And over the years, people have said,
you know what, I really identify with Dave
in that one story of yours.
That is me to a T.
And gosh, I would have loved to learn more about him
and his story and how he solved it.
And that went with just about every other
client connection story I had in all of my books.
So I thought, do you know what, let's just flip this
on its head and let's make this
more about the patients I've helped,
integrating some of these concepts,
but it's not so much anatomy and physiology heavy,
it's more of my thinking and how we worked
through their problem.
So my hope is that I want to give,
because some people, they don't like a lot of anatomy.
It confuses them and all that kind of stuff.
So these stories are for those people
who maybe want to hear more about how I helped a person
rather than the anatomy and physiology behind a pain issue.
- So this book is much more for the lay person
versus a therapist.
- Oh yeah, definitely.
You know, my other books I thought were for lay people too,
but apparently not enough, and so this one's
definitely for lay people more.
But also, I'm always trying to reach therapists
and other medical providers because this is
a whole new paradigm of thinking and working with the body.
And so this book is kind of my proof
of how and that it works across all types of injuries
and populations, ages, what have you.
And they're all chronic pain stories
of people who just couldn't get solutions
with anyone else and were at the end of their rope.
So that's the kind of person I typically see.
- So could you give us one of the stories from the book
or an example from it?
- Yeah, well I can do even better.
On my rickolderman.com website,
you can read three of the stories.
I've put them on that site, and I've also created
audio files of those three stories
so you can just listen to me reading it if you want to.
But one of the stories, let's say,
well, one of them was this guy with sciatic pain.
And he had had this for, I think it was eight years.
And he came into the clinic really skeptical
because he had been around the block.
He had even had, I think, two surgeries
to correct a disc bulge and he had a laminectomy
to release pressure on his spinal column.
It didn't help.
He had been to all sorts of other types of practitioners.
Nothing was helping, and so his doctor,
because I had worked with a lot of his doctor's patients,
his doctor finally said, hey, you should really go
see this guy.
Anyway, he was so doubtful, but in our very first session,
and everyone told him that it was coming from his back.
After evaluating him, I didn't think it was coming
from his back at all.
And so in our very first session,
we completely took all of his eight years of pain away
and it never came back, with just one exercise.
And what it was, it ended up being a hip tracking issue,
and I solved those pretty fast using a butt pump exercise.
So I had him roll over on his hands and knees,
he did two sets of butt pumps.
He rolled back over on his back to do his straight leg test,
and his leg just shot up 90 degrees.
No pain at all.
He did it like 10 times in a row.
He couldn't believe it.
And as long as he did his butt pumps, his pain was solved.
- You had me do those butt pumps yesterday, didn't you?
- I did.
- If people are listening, Rick made me
try to figure out my hip pain,
and he goes through those in the videos.
So if you want to watch what he's talking about,
I can link it down below.
- Yeah, yeah definitely.
And this is why everyone thought he had a back issue,
because it was sciatic nerve pain.
And so the assumption is that it must be coming
from the spine.
And so that's where everyone looks,
because that's what we're trained to do in medicine.
But what we're not trained, and this is what
I'm trying to get through in the book,
is that my approach is a systems thinking approach.
It looks at the entire body in terms of how it's working.
This is really how the body works,
and this is why we have chronic pain,
is because we're not trained to look at the body
as a system.
Strangely enough, you would think in physical therapy
we would be trained to do this.
But we haven't been.
We've been trained to look at it as a series of components.
And so these 25 years, I've taken the time
to put all these components together
into a unifying approach to solve chronic pain,
and this book is basically showing the readers
how this stuff works in simple terms
to give them hope that you're not broken.
We can fix these things.
- So is this book more like stories,
or is it also the exercises as well?
- It's not the exercises, it's the stories.
I've provided the exercises in my Fixing You series.
- Yep.
- So these are the stories, because I think they'll help
people see how this works in maybe them.
If they have sciatic pain and they haven't had help
and they read this story of this guy
where the butt pumps, where no one else
had even looked at his hips,
and this is why he had chronic pain.
This is what I'm trying to say, is you know,
and I have another story on my website
for three people with migraines and neck pain chronic
that had nothing to do with their neck and head.
It was their shoulder girdle complex that was causing
all of this stuff.
But no one looked at those things
because they don't understand the connections,
how they're connected.
And this includes neurosurgeons, orthopedic surgeons.
It's not their job to really understand these connections.
It's our job as physical therapists,
so I don't blame doctors for not knowing this stuff.
I do blame us as a profession for not knowing it
because people far smarter than me
have been doing this stuff for much longer than I have,
but that's not where our focus is.
Our focus continues to be on understanding tiny and tiny,
smaller and smaller components of how the body works,
but not how the whole thing works,
and that's why I think we're missing.
That's what my book is about.
- So Bob has said that, from reading your books
and taking your courses, that you go through
some extreme lengths to solve patient problems,
meaning you call the doctors, you do your research,
that's the extreme length.
So do you look at each case as a personal challenge?
- I do.
Once I am on someone's case,
they do not shake me until they're better.
And there's only one story in that book
where I couldn't solve this person's pain.
I still haven't been able to solve her pain.
She has very unusual issue going on.
But this is the problem, is that a lot of her practitioners
are not trying hard to figure it out.
What they're doing is throwing the standard tests at her,
and when things come back negative,
they're just like, oh well, I didn't see anything
so I have nothing for you.
And it's just like there's no one really
taking up the gauntlet, and that's what I typically do
for my patients, is look, we're gonna get through this
one way or another.
If you need surgery, I'm gonna help you with that
in terms of guiding you that you need the surgery
and helping you with that rehab.
And if you don't need the surgery,
we're gonna figure out what's at the bottom of this.
I just don't give up.
And that's what drove me.
I realized after writing this book,
I think I have a little bit of OCD and anxiety,
because I was just so haunted by every single patient
who wasn't getting better.
I had to understand why or else I felt
I wasn't doing my job.
And so that's what led to the uncovering
of all of these ideas that are in this book
and in my Fixing You series of books.
- Well, that's just a good physical therapist,
because most people just, when they're off your case load,
you just kind of forget about them.
- Well yeah, yeah.
I put a lot of pressure on myself to solve this stuff,
and I feel that there is a bit of anxiety
and maybe OCD involved here,
because I was just maybe a little bit too committed.
- As long as you use it in a good way,
there's probably not a problem with those things.
- Well, that's a good example of using
what could potentially be a negative for a positive.
- So have you, I know we've had this happen,
but have you had people come see you
and immediately you're just like,
I think you just need to have surgery?
- Yes.
- Has that ever happened?
- Sometimes that happens.
Rarely, but it has happened before.
I had a young guy, and he had shoulder pain.
I evaluated his shoulder.
I was pretty darn sure that he had a labral tear.
- Oh.
- And so I sent him back to his orthopod,
and I said, please give him an MRI.
I believe he has a labral tear.
Well, the insurance company refused to do that
because I didn't spend 10 sessions with him.
Well, if you're sending him to me
because this is my specialty, this is my assessment,
this is what I think he needs,
why would I spend nine more sessions with him
wasting all of our time if I'm 99% sure
he has a labral tear?
And so because that happened initially,
he would never get that MRI.
And so no one could ever confirm it
because once it's refuted by the insurance company,
they never change their mind again.
- Yeah, so what happened?
- You know, I told him I'd work with him,
but I don't think it would work,
but I would be happy to see if I was wrong.
But he was just like, do you know what,
if that's what you think is going on, you know,
and the insurance company won't do it,
I don't want to spend nine more sessions seeing you
for something that you probably won't be able
to help me with.
That just seems like a waste of my time and money.
So I said, fair enough, but if you end up having an MRI
and getting shoulder surgery, please contact me
and let me know what's going on.
And I never heard from him again.
I think he's, like so many, this is one of the things
that I've learned, is when I had my first job
out in a small town in southwestern Colorado
and I couldn't solve people,
I thought I was a really terrible therapist,
and I was, because I didn't understand any of this stuff.
But then when I moved to here, Denver,
and I went to work in a really busy athletic club
as their physical therapist, and they had never had
a physical therapist at their club before,
my schedule was instantly full of tons of people
with chronic, nagging pain issues.
All of these people could afford any treatment
that they wanted, but no matter what they could afford,
no one could give them the answers.
So I realized, oh, this isn't just me
being a terrible therapist.
Something is failing all of these people.
And you know, I just decided I could either quit
physical therapy or I could try and figure it out.
And so I went the second route.
- I think everyone's glad you went the second route.
- Well, I don't know.
I hope so.
I mean, it's made my work so much more rewarding
knowing that pretty much anyone who comes to see me,
I know I have something for them.
So it's been rewarding.
And my anxiety level has gone way down.
The more answers I get, the less my anxiety level is.
- All right, so what do you hope people will get
out of this book?
- Well, my first and foremost is I hope that they can find
something of themselves in some of these stories.
And if they can, then they should be given hope.
Because this is the thing that I see in most people
who came to my clinic who had been
through a lot of practitioners is they had lost hope.
They were skeptical anyone could help them,
there was nothing new under the sun.
You know, I went to the best, I went to the Mayo Clinic,
I went to the Cleveland Clinic,
I talked to the top surgeons, I talked to whoever, you know,
and no one has been able to help me.
And this is because they're all working
off the same kind of information
and the same approach to looking at you
which is this component approach, looking at structures only
and not understanding the system.
And so my hope is that people reading this book will say,
oh, I didn't even know this kind of stuff was possible.
Maybe this is what's behind my pain.
And that's why I thought going more
into the people's stories, rather than me talking
about the anatomy and physiology, would help people see hope
that they can be helped, and find that help.
- So where can people go to find more information
about you or pre-order the book?
- Well, you can go to rickolderman.com,
and you'll see you can pre-order the book there.
And then I've also got home programs
that people can download to solve their pain,
which is based on a lot of my last 25 years' experience
and all those concepts that I used in those home programs
are found in this book too.
And then if you're a practitioner who wants to learn
this approach to solving pain, I also have a link
to my online practitioner's course there too.
- And like I said in our other podcast,
Bob and Brad are taking your continuing ed courses.
- Yeah, yeah.
- They're finding them very helpful.
- Well, I'll tell you, it's a completely fresh
and new perspective on pain and why we're having it
and how our bodies should be working.
And I feel, part of me's just like, are you kidding me?
Who are you to get up here and talk about this stuff,
because I just consider myself an average.
I'm not like super human intelligent or anything like that,
but I am tenacious, and I did have that anxiety
that drove my search for all of this.
And I think that's the only reason I figured it out
is because I was just tenacious and I felt I needed to
in order for me to feel mentally healthy.
- So is there anything else you want to add about the book?
- No, I just hope people, it would be great
if people pre-ordered it.
I'd love to be the first physical therapist
that reached the New York Times best seller list.
But anyway, I think there's a lot
of valuable kernels in there.
And if you watch all of these videos
and you're still not sure what I'm doing
or what I'm talking about, this book will really help
give you a more complete idea
of really what I'm talking about with all of this
systems thinking stuff and how it applies to real patients.
- So is there an audio book too,
because you said you read some of it.
- Well, the publisher who is publishing the book
may ask me to do an audio version,
or they may hire someone to do an audio version,
but for the three chapters I put on my website,
I just decided to just do the audio versions myself.
So they're me just, I don't have a professional studio
to do all this stuff in, so it's just me
reading the chapters because some people prefer that.
- Sure.
All right, well thank you for joining us again.
- Thank you, Mike.
I really appreciate it.
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