Episode 50: How To Be Pain-Free While Working with Emile Clarke, PTA, CEAS

Show Summary:

Many of us know the feeling of the tight shoulders, sore back, and tense jaw that come from long hours working at a computer. In the age of virtual work, it’s all too common.

What can we do to keep our body healthy while working? Today’s guest, Emile Clarke, is here to tell us his best secrets for working and moving to reduce discomfort and pain.

Emile Clarke is a Certified Ergonomic Specialist with an extensive background in outpatient Physical Therapy and Corrective Exercise. He has helped more than 6000 clients reduce their risk of injury and improve their overall functional fitness. His specialty is in office, vehicle, healthcare, and Industrial Ergonomics/ Injury prevention.

Don’t miss this conversation that will help you better understand how to optimize your ergonomics while working and how to live and move to reduce pain.

Timestamps:

0:00 - Introduction

2:00 - What motivated Emile to become a physical therapy assistant?

6:03 - Can everyone optimize their bone and muscle health?

8:33 - Which conditions Emile specializes in

12:33 - Typical pain that shows up

17:30 - Are we sitting too much?

20:17 - Power of moving together

23:38 - Ergonomic recommendations

25:23 - What can we do to move our bodies optimally

28:24 - How to move with chronic pain?

35:22 - Breathwork

41:31 - Nutrition and hydration

44:55 - Morning routine

48:33 - How to work with Emile

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Full Episode Transcript:

SPEAKERS: Dr. Andrew Wong, Emile Clarke, PTA, CEAS

“Common thing that I always hear when people, they'll say like get shoulder pain or elbow issue and then they stop moving, in general, well you can still move your lower extremities still work so like don't stop working out don't stop going to the gym don't stop doing everything because your elbow what about your legs you can still go for a walk you can still work your legs or vice versa. If someone hurts their knee you can still do other stuff with your arms as well. So never stop moving and find something that you enjoy doing that helps you to move and be intentional about moving every day, be intentional about just finding ways to move and just create it, get your heart rate up regularly.”

Many of us know the feeling of tight shoulders, sore back, and tense jaw that come from long hours working at a computer in this age of virtual or hybrid work it's all too common. What can we do to keep our body healthy while working or while living? Today's guest Emile Clarke is here to tell us his best secrets for working and moving to reduce discomfort and pain.

Emile Clarke is a certified ergonomic specialist with an extensive background in outpatient physical therapy and corrective exercise. He has helped more than six thousand clients reduce their risk of injury and improve their overall functional fitness. His specialty is an office, vehicle, healthcare, and industrial ergonomics and injury prevention.

Don't miss this enlightening conversation with Emile that will help you better understand how to optimize your ergonomics while working or just living overall and how to move your body to prevent and reduce pain and optimize your health.

Dr. Wong

Thank you Emile for coming on today. Welcome and we're so glad to have you here.

Emile

Thank you so much. I'm excited.

Dr. Wong

So, you work with Hiza, Doctor of Physical therapy here and you have your own ergonomics practice as well but I'd love to kind of go first broadly you know about what motivated you to become a physical therapy assistant and certified ergonomics specialist.

Emile

Awesome. So, I guess let's go further back. So, I've always, since I was a kid I've always loved muscles and bones, and movement that's always my thing. I did play some sports but I just, just always love muscles and bones like I always find that so interesting right you got a bunch of levers and pulleys. So it was just extremely interesting so I know I wanted to do something related to movement in that sense. So yeah, I went to school went to Towson University, graduated, did some exercise science work, and then worked in the fitness industry for years. I worked for some of the top gyms. I was a manager at Bally's and did a lot of stuff in fitness and then I just kind of got tired of the random schedules like you might have a client in the morning and then late afternoon it was just all over the place. So I wanted to stay around muscles and bones but at the same time I didn't. I want something more stable than the personal training. So that's when I went back, got my physical therapist assistant license and then a whole bunch of other certifications and

3:02

movement um advanced therapeutic exercise specialists and um Kinesio taping and a bunch of other search um

3:10

yeah and that's how i uh end up going back and went that direction. as far as the ergonomic side of things

3:16

one of my clinical affiliations um i uh i shadowed or i did it it was like a six

3:22

week affiliation and i got to work behind a uh an ergonomics uh specialist

3:28

and she actually owned the whole her, whole her ergonomics business it was one of the largest ones in this area so i

3:33

was right side person uh for six weeks which was an amazing experience um so

3:39

yeah so i went and got that and she was actually a a therapist also so yeah so

3:44

did that and then i just loved it i love the um figuring out how to help people how to serve people um so obviously

3:52

with ergonomics you like with physical therapy right we it's more proactive i'm sorry it's more reactive

3:59

right after someone gets injured but like more ergonomics is more kind of reactive right so like how do

4:04

you avoid people from getting hurt in the first place was like i'm sure we'll get into that but how do you avoid getting hurt in the first place and then

4:11

um and obviously if someone does get better from physical therapy but

4:16

they're going back to the exact same environment then it's like you're undoing everything right so yes that's

4:21

in a nutshell how i got to where i am.

Dr. Wong

thanks emile and i think like you said in the beginning healthy muscles and

4:27

bones it's really a foundation one of the big foundations of health is is structural health you know if you have a good

4:33

structure and we talk in biology about structure and function you know if someone has a good structure then their cells their

4:40

organs their tissues are going to be more functional as well they're going to perform better i'd love

4:46

to hear your story of of um a little bit deeper into how you got into like healthy muscles and bones was something

4:52

that happened as a child do you like certain sports was it a family kind of thing or

4:59

yeah so i played like some basketball um and i i i mean and anyone play

5:04

basketball knows you're gonna have a lot of ankle rolling you're gonna have a lot of like i just heard a bunch of

5:09

different things um now i can't play as much i'm 36 now um so

5:14

every time i play i heard something and so i was like i had to retire but uh so it was just always interesting so like

5:20

when i'm watching sports like when i'm watching basketball and watching these things i would i'm paying more attention to how

5:26

people are landing after they jump i'm paying more attention to like the mechanics of it um and so i was also

5:32

interested in like what the body is doing and just the physiology of these athletes how amazing

5:38

they are like their cardio respiratory health is like advanced they're like superhumans they're literally super humans pro athletes like their body are

5:45

capable of doing things that the average person can't do not only strength but flexibility range of motion is all these

5:51

little things that make them such phenomenal athletes right people don't don't see all this behind the scenes um

5:57

things that they're doing so yeah so that i always find that extremely interesting

6:03

so superheroes you know we're you know now this is the era of a lot of marvel movies you know and everything

6:08

um do you feel like everyone has the potential to optimize their bone and muscle health and become their own superheroes

6:15

i do i absolutely do um and uh like one of the things that i always do my patients and my clients is

6:21

just uh to get them to understand what is your peak kind of your peak condition right so

6:28

like the last day that you had a really good day that you knocked out a lot of things like like in your in your

6:33

day-to-day life right whether it be you is extremely productive like what were the conditions right so like that that

6:39

you did so i know for me like sleep is very important like so like the days that i'm most productive is the

6:46

days that i get good sleep um obviously i eat a lot of fruits and vegetables um

6:51

if i start my day with some movement some pull-ups some type of exercise just to kind of get some control of my day if

6:57

i do those things in the morning so sleep proper nutrition and some movement in the morning like i have so much more

7:04

energy and i'm able to function at a high level and get a lot of the things that i want to do my brain is so much

7:09

more clear i just feel overall better so i think it's it's just important to to to try to

7:15

exist in your in your peak state right so like try to try to be the best version of yourself every day so that

7:21

you can uh just be as productive as possible so and having that morning routine is really one of the keys to

7:28

having that that peak state you know we just also talked with a guest about how

7:34

um basically um repetition and and rituals like routines create resilience so i

7:41

think we can say that both you know mental emotional resilience but also physical resilience the body will last

7:48

longer and and be healthier if we have that routine down

7:54

yeah absolutely i absolutely agree that's why it's important to try to wake up at the same time every day

8:00

and try to try to as opposed to being all over the place i know i'm it's hard for me i know but i really try to

8:06

because some days i have a patience at like 7 00 a.m some days i don't have a patient until like 9 a.m but still to

8:12

try to get up at the same time every day because you want to hit that snooze you want to stay in bed longer but like it's

8:17

important to kind of get that circadian rhythm um to get up at the same time every day

8:23

so would you say would you say even as a pt assistant and ergonomic specialist

8:28

that that uh movement also will be influenced by your routine right as well

8:35

absolutely yes the movement is definitely uh i would definitely say that

8:40

uh and let's talk about emil what kind of conditions overall you work with most often because people might be wondering

8:46

like what is it exactly that you you like to do or like to specialize in

8:51

awesome so um so the majority of my clients well let's

8:57

start i guess with ergonomics um so the majority of so i specialize in

9:03

several different um areas so first of all like office ergonomics is probably like what i've done most of my work in

9:08

so i've probably done over 6 000 assessments um so different things like

9:13

um so if someone is having chronic pain at work but they don't have pain when they're not at work right so that means

9:18

there's something in the work environment that they're doing that could be causing that discomfort so what i do i go in and assess i observe them

9:25

see what they're doing i interview and see what are the repetitive things that you're doing right so ergonomics when

9:31

it's more a lot of these injuries happens from repetition and frequency

9:36

right so free or sorry frequency and duration right of of certain things so for example um if if your monitor is too

9:44

low or if your mind is too high or if your chair back is unlocked right then you're not getting that proper back

9:50

support a lot of people don't know like that puts more stress on your back um if your feet are floating right so like if

9:56

you're sitting down and you don't have lumbar support for the more shorter people if your feet aren't touching the ground

10:01

that can put a lot of stress on your back is these things that people just don't think about if you're referring to a lot of documents right so if um your

10:07

your job has you referred to a lot of paper documents but you're putting it flat under the table and you're constantly doing this right so that that

10:14

repetition over and over and over can kind of cause strain in your neck when i all you need is a document holder

10:20

something to angle the document so that you can keep your neck neutral and view that document it's all these little

10:25

things um if someone is using the phone a lot like i work with a lot of administrative people

10:31

who are using the phone often and they're cradling the phone like this and it's giving them neck issues um that

10:36

could cause a problem if someone wears progressive or bifocals lenses as opposed to like regular lenses so a lot

10:43

of people don't know but these people need to keep their monitors lower right and the reason for that is because the lower half of your lens is uh is uh

10:52

is uh is more for like reading and close-up viewing right so a lot of times i'll do an assessment and i'll go in and

10:58

i'm observing the uh the employee or patient they're doing this and i said let me guess you have progressive lenses

11:05

and they're like oh yeah how did you know i said you had the typical sign and they'll say i don't know a meal like for some reason my neck just hurts every day

11:12

like and i'm looking at them like this i'm like yes and then i send a picture and i'll take a picture and show them i

11:17

said you're looking up all day long and that might seem like something so small but after nine hours of you looking up

11:24

just that little small change in your angle over such a long period of time can cause problems so anyway in the

11:29

office setting that's what i'll do chair fittings um kind of decreasing any ergonomic risk

11:36

and then the as far as like an industrial setting and healthcare like i helped to lower workers compensation cases so like any um position almost

11:44

like industrial hygienists that's another title for what i do in that in that in that setting so a lot of nurses

11:49

they hurt their back for example so i do lifting clinics show nurses how to move better how to lift better give them

11:54

stretches that they can do um also with night management i might need

12:00

to make some changes as well to uh to kind of decrease strain so how do you lower chances of people getting hurt at

12:06

work and then industrial setting there's a lot of different things that you can do to add different tools to decrease

12:12

grip changing and grip strength so there's a lot of tools that people aren't aware of that can help to lower injuries as well

12:20

and we still need to have you come in here i think and do a whole office assessment i don't think we've done that yet but um we know that you have done

12:27

some here a little bit at the front but it'd be great to do that for everyone here i

12:32

think if you look at this you know working and you know sitting down using the computers a lot and and

12:38

probably like you said repetitive uh motions you know over and over day by day and that that frequency and duration

12:45

will end up causing a lot of a lot of injuries what what what are the typical let's say for ergonomics and then i do

12:51

want to get into other things that you do but um ergonomics wise what are the typical body cues that we might

12:57

experience if the workspace is not optimal yeah so

13:03

some of the most common things that i'll see like probably by far the most common issue that people have is like tightness

13:08

in their shoulders right and the neck and the traps and also between their scapula and that's because people so

13:14

many of us have such poor posture right so like if you're here in front of a computer all the time gravity is going

13:19

to automatically want to pull you down here right and especially now if you're working from a laptop that is probably

13:25

by the way so that's a big gym i want to give um uh people so if you work from home using

13:31

a laptop that is literally one of the most stressful things you can do to your body that's probably the most common things that i've seen since so many

13:37

people started working from home during pandemic like just working from a laptop and doing this all day long

13:43

excuse me that puts a lot of stress and strain on your back because you're your eyes are trying to find that horizon so

13:48

you're always kind of looking down like this right so what's better raise your laptop you can put it on a

13:54

shoe box you can put it on a laptop stand something so where you're looking straight ahead and then put the elder

14:00

your keyboard and mouse should be on your table so you want to look straight ahead keyboard and bouncing the table um

14:06

and uh and if you do work from home um get a designated workstation right so i've seen a lot of people just create

14:12

makeshift stations um since i started working from home at the kitchen table or working from their bed or just

14:17

working from this area so if you're gonna continue to work from home um at least two three four days a week get it

14:23

at school desk a chair um an actual like full set up because uh if you're just

14:29

kind of doing these little works uh make sure stations that puts a lot of strain on your body over time um i got away

14:35

from your question what was the question again no i think i think basically you were saying um specific body cues or

14:42

symptoms i think you said upper back and neck pain are there any other symptoms that you would

14:47

say are very common in this situation with ergonomic imbalance

14:52

absolutely um carpal tunnel a lot of hand and wrist problems um that happens a lot of times

14:59

i'll see carpal tunnel injuries from um like uh like their wrist rests you know the little gel wrist rests that a lot of

15:05

us have um and so i wish i had one but like a lot of times you have like the

15:10

flat um i guess the flat little foam thing and then you have the little like cushion at

15:16

the top right of the wrist rest a lot of people they'll rest their wrist on it right when and that puts a lot of

15:22

compression on that median nerve right and so and so over time that can

15:27

actually damage the nerve and you get carpal tunnel that's probably one of the most common reasons people get carpal tunnel because from typing and then and

15:34

then twisting their wrist and not using the ergonomic keyboard um or just twisting over some type of way so when

15:40

you if you are going to use one of those palm one of those gel wrist rests you want to actually keep your mouse close

15:45

to it so that um and if it's like this you want to keep the the mouse close to it so that

15:50

that median nerve can still flow under go underneath right so it's kind of hard to demonstrate right now but yeah so

15:57

keep the you don't want to press that wrist keep your wrist on that gel part you want to use it to keep your palm

16:02

the medial nerve yes yes so that's a common one um also like if your desk is too low

16:08

in relation to your table so then the um the edge of the table is pressing on your right the corner edge of the table

16:14

and if your keyboard is further back it's pressing on that area again so that can cause a lot of um like carpal tunnel

16:20

issues and so forth so you want to get an ergonomic keyboard or ergonomic mouse and there's a lot of different ones that

16:25

you can recommend but i'll say the most common things i'll see is neck problems back discomfort and hand and wrist

16:31

issues and to get a good idea of is this coming from your workstation think about it like are you still having these same

16:38

issues when you're not doing not when you're not working right so that's how you can isolate it to

16:43

that to to specifically come from something in your work environment i think i think headaches too have you

16:49

have you seen because then we know that there's referred pain up up the head on the neck and back too that that can

16:55

be one too um that i've seen um let's talk about oh guys okay sorry to cut you

17:00

off as far as headaches also um a couple of other common things that i've noticed with headaches if your eyes are dry so

17:06

you might um when um so that can cause a lot of eye strain if the font is too small to strains your eyes so then you

17:12

want to do like a control shortcut and zoom it big that will do it too and then also the lighting positioning so like if

17:18

you if um for example if my window right here was open and the light in the sunlight is right behind my uh

17:26

um on my laptop and giving me glare that i've seen a lot of times that cause headaches or if the if the light source

17:32

is behind my monitor and then um and there's a there's a there's a window behind here

17:38

then again that that lighting can cause a lot of irritation too it's best to have the light source coming from

17:43

the angle from the side so like if i'm in a if i'm in my office so then the

17:48

window should be to the side at a 90 degree um yeah so that's so that it does so there's no glare you never want to

17:54

have glare in your screen because that's another common source of headaches got it okay interesting um

18:00

i just had a deeper question about about work in general are we are we sitting too much you know are we working

18:07

too much at our at our laptops or desktops or whatever yep that's a great question so i get

18:12

that i get that one often so and people always say oh sitting the new smoke in and so forth uh so what a lot

18:19

of people don't know is that standing is actually a sedentary posture as well so

18:24

sitting too much or just standing too much in one spot is a sedimentary posture as well sanitary just means that

18:30

sedentary just means you're not moving right so what's best to do is to move

18:35

every hour so try to get up and move right so change position and move every hour a couple of tips that people who

18:42

are best with it they have some type of reminder because you know like when you get stuck into work and you type in it's

18:47

like that hour or two goes by like this so um so the ones that i like for android is called um break reminder it's

18:54

an app that you can get and then for iphone it's called stand up and so it's just really easy you can automate

18:59

instead of say monday through friday between 9am and 5pm just give just alert me or chime me every 45 minutes and then

19:07

once you hear that beep just get up for a couple of minutes do some shoulder rolls maybe do a short walk up then they

19:12

come back and go to work um or smart watches that will do the same thing they'll have a sedentary reminder most

19:18

small smart watches the one i got on amazon is like 60 so you don't have to go get a 800 apple

19:23

watch just something that has a reminder to get up and move every hour because again as human beings we're made to move

19:29

we're not made to stay still right so so yeah so that's why i always try to explain people like because they always

19:35

want to go and get a standing station i said just understand it's good to be able to alternate between sitting and standing but you still as human beings

19:42

are made to move right motion is lotion right you want to move lubricate those joints right get that get that blood

19:48

flow to that circulation use that if you don't mind yeah motion is lotion motion is lotion yeah the best lotion you can

19:55

have right internal lotion that's it you only get one uh one body um it's almost like a car right if you're not uh

20:02

getting your oil changed right you got these parts that have to rub against each other if you're not getting the oil change and you're tuning up then this

20:07

can start to break down the only thing is you're stuck with this vehicle for the rest of your life you only get one of them you better be good that's right

20:13

right now can't can't really replace it um the the the other thing is that blood flow you know the cells like all of our

20:20

tissues everything's dynamic in the body it doesn't seem like it because we can't see that but all these

20:26

cells and all these you know tissues and blood is moving so quickly throughout our bodies so we're moving even if we

20:32

don't think we're moving i think if we if we kind of move um like you said it's not really about

20:38

sitting versus standing it's really about moving versus not moving and and moving you know at least every hour like

20:43

you said is really good advice i feel like it's very hard to remember sometimes about that when you

20:50

get kind of caught into like what you're doing throughout the day um what do you think about having kind of a community

20:56

approach and having people kind of do movement together like i know sometimes we've been trying to do jumping jacks

21:02

here at the front desk and that's been that's been pretty fun i love it and without another thing i've

21:08

seen like in the office space people will have walking meetings right right so they'll take walking

21:14

meetings and um and like the like the whole group they'll go out for a walk um outside for walking to take

21:20

that meeting so that's been pretty cool to see that um and they just take moving breaks yeah so so sometimes like uh

21:27

office spaces will have a movement champion um and personally just to stand up and then someone leads it every week

21:33

they'll do some sort of rolls and there's like different stretches that you can do um and if anyone is interested they can i can you can

21:39

definitely reach out and i can give you some kind of like daily stretches but like there's certain things that you want to do to just kind of combat the

21:45

effects of sitting all day so like right stretch out your wrist you want to stretch out your scapula your shoulder

21:50

blades because those are the ones that get tight um stretch out your hips so there's a lot of different things you can do to just combat the effects of

21:57

sitting or they stretch your hip flexors the hip flexors should be stretched almost daily so that's another one that

22:02

people don't stretch their hips because if you're always seated in a short position your hip effects are always in a shortened position

22:09

and you try to stand up and then again you get that like that like it can increase that lordosis and you can add to back pain so you want to definitely

22:16

make sure that you're stretching and moving um often um another point that i wanted to make sure i hit

22:22

um for for those that work from home um specifically you're going to be at

22:27

higher risk of a lot of different issues and i've seen a lot of things happen in uh over the last couple of years so

22:33

since so many people have been working from home there's been a lot of increase in orthopedic conditions and a lot of

22:39

health issues just because they're supposed to get 10 000 steps a day ideally right that's what the kind of

22:44

cdc recommends but people who work from home get like get half as many steps as people who work in office

22:51

right so i think it's really important because a lot of people are staying working from home and i would say probably a good percentage of my clients

22:58

are working home and they're just working from home and they're barely moving and they're developing a lot of issues that they never had before the

23:03

pandemic and a lot of it is just due to lack of movement um so anyways i say i

23:09

say that to say i always like to give a solution right after i scare you so i say all that to say um if you are

23:14

working from home again back to the whole smart watch then get a small watch monitor your steps so a four o'clock

23:19

comes in like man i only got 2 000 steps today um you might want to go outside for a walk

23:24

right so be intentional about how many steps that you're getting how much movement you're getting um on a day-to-day basis i'm big on

23:31

lunchtime walks also so like break up the second half of your day uh with some with a walk now you want to

23:36

go outside get some sunlight get some vitamin d which is just good for so many different things so i'm really really

23:42

big on taking lunchtime walks uh and getting some sunlight and just walking outside in general um i like i'm big on

23:48

doing your cardio outside as opposed to inside just because we spent so much time inside so as opposed to the

23:53

treadmill but go outside get some sun as human beings we need that sunlight so um

23:59

and you'll notice you'll feel so much better the second half of your day if you take that less time walk so yeah definitely give it a shot yeah i agree

24:05

outside movement is is definitely better if you can for sure out either morning or evening or at lunch time like you

24:12

said and you talked about smart watch you talked about some of the the resources some of the hip flexor other

24:18

stretches we can we can kind of highlight your social media at the end of this in a bit too um any resources

24:25

other resources you recommend like i'm thinking any specific desk setups or ergonomic setups

24:31

for people to learn more about uh yeah so

24:36

as far as like desk setup you do you do you mean like uh what are like some specific desks that people can get

24:43

yeah that that or other ergonomic resources you know to help their posture and and i guess also the movement

24:48

resources anything else you recommend there yeah so um so as far as like i'm gonna give some

24:55

specifics so like for anyone that's having like a wrist pain or hand up issues um like i like the microsoft

25:02

sculpt keyboard and mouse that's my favorite ergonomic keyboard it's microsoft sculpt um so that's like more

25:08

of like specifics as far as chairs uh like a steel case has some good options herman miller has some really good

25:15

options in hayworth so i check out those brands those are probably my favorite my favorite chair and what i use is the

25:20

steelcase leap or the the um the hayward zoe chair so those are probably my

25:25

favorite ergonomic chairs as far as like the foot rest that's not a huge deal there's like different foot rests um

25:33

yeah so that's like more specific on equipment now as far as like other resources i know um the cis i did a more

25:40

specific ergonomics um uh like was that like a workshop which

25:46

should still be on our youtube page so um if you want more specific ergonomic tips i know you can go and see that

25:52

obviously and then you can also contact me as well um on my uh my

25:58

my website is elevationhealthergo.com or my instagram is ehe underscore

26:04

movement so ehe underscore movement i post some good tips on there as well

26:10

what does ehe stand for is that elevation health uh i think ergonomics got it got it

26:15

great okay we'll make sure to emphasize at the end as well outside of the workspace emilia what can we do more to move our

26:22

bodies optimally good question so um so i started the workspace just find

26:28

something that you enjoy doing that has you moving right so everyone likes different things so like i still do a

26:34

little bit of basketball i do pull-ups i like like meditative stretching so i i do a full body stretch while i'm doing

26:41

my deep breathing and that also helps but just find something that you like to do right that that requires you to move

26:48

whether you go and bounce the ball you go run with your kids you take your dog out for a walk just find ways to move

26:54

right we are made to move as human beings um and if you're just sitting around all day that's one of the worst

26:59

things you can do for your health is just not move um so yeah just get creative find ways to move um i know a

27:06

common thing that i always hear when people um they'll say like get shoulder pain or

27:12

elbow issue and then they stop moving in general well you can still move your lower extremities still work so like

27:17

don't stop working out don't stop going to the gym don't stop doing everything because your elbow what about your legs you can still go for a walk you can

27:24

still work your legs or vice versa if someone hurts their knee you can still do other stuff with

27:29

your arms as well so never stop moving and find something that you enjoy doing

27:34

that uh that that that helps you to move and be intentional about moving every day be intentional

27:41

about just finding ways to move and just create it get your heart rate up regularly um

27:47

yeah i'll say that was the biggest thing i think a number of a number of people uh you know including myself are on social

27:53

media and you see these people in these like you know amazing gym shorts and you know they're they're they're like

27:59

sculpted you know they're like the you know the magazine models or whatever and i'm wondering about how this impacts our

28:07

ability to even start moving you know like one of the common issues that i find sometimes

28:12

is sort of like oh i don't really feel like moving because i can't do it that well but maybe we don't want to let

28:19

perfect be the enemy of the good like how do we just get started with movement with movement i think

28:25

yes that's a good question yes so it doesn't happen i think it's really important to uh excuse me

28:31

be patient with yourself you know it doesn't have to be perfect just starting off with just something just simply

28:37

going out and walking regularly right you know you don't the goal doesn't have to be to be shredded and and have these

28:44

big texting biceps just the fact that you're getting out and walking and moving regularly you're going to get

28:49

some health benefit right so just be patient with yourself it doesn't have to be perfect and i always say like one

28:56

percent just try to get one percent better every day right one percent two percent better every day adds up a lot

29:01

over a course of a year all right so just con try to always just move forward um and

29:06

just try to get a little bit better every day step by step and then yeah and and like you said something

29:13

enjoyable something you can do step by step that you can gradually increase one to two percent at a time i

29:19

know that husa works with a lot of people like this too i imagine you two people with with chronic pain what would

29:24

you recommend for people with chronic pain let's say you know kind of all over even but then they want to increase

29:30

movement yeah some chronic pain so that's an interesting one right because um

29:36

it's almost like what comes first the chicken and the egg right a lot of times people don't want to move because they have pain right but the problem is if

29:43

you don't move then you you then you get more tight you get more stiff you lose your range of motion then you have pain

29:50

right so it's like you don't want to move because so it's like do you have pain because you're not moving or do you

29:56

or or or are you not moving so which causes you to have pain so it's like it's like

30:02

which comes first so um so back to that um i think it's important to just find ways to that you can still move so like

30:09

if you again you have chronic pain in your in your legs for example or in your knees for example so then you can still

30:15

do punches you can sit down you can do arm curls you can you can do stuff for your upper extremities so find things

30:21

that you can do still that won't hurt right and that's kind of like what i

30:26

specialize in so like post rehab fitness post rehab exercises so like um outside

30:31

of just like physical therapy so a lot of my clients or patients like after they get discharged from physical

30:36

therapy they can't they're not ready to go to the gym but um yeah because they don't know what to do

30:42

they still have functional limitations so like my spouse is supposed to rehab fitness and building strength and

30:47

conditioning programs for people who have issues right and they're limited to what they can and can't do but they still want to

30:53

work out so it's important to just find things that you can still do right so i've realized there's a big gap there

30:59

right do you have the gym you have physical therapy but what about what's in the middle right

31:04

um and so yeah so it's important to just again find things that you can that you can do find a good coach who can give

31:10

you tips and give you exercises that you can still do to also maintain right so after you get discharged from rehab

31:17

for an issue that you might have chronic pain for you have to keep up your exercises we know that um

31:23

dr he's and i was talking about this other day but we know that over 90 percent of people fall off their their

31:28

home exercise program within like 60 days so like when we discharge patients from physical therapy we give them a set

31:34

of exercises and stretches to do and so you have to keep these going because your issue is going to come back your

31:39

career especially if you have like a pathology or like a like actual structural issues so this

31:44

this by getting these certain muscles strong that's going to help to decrease your symptoms but you do have to

31:50

maintain it and so a lot of times people don't have that accountability um to and aren't able to maintain it so

31:56

that's why they end up in physical therapy again right and it's it's this whole cycle thing but you have to be really helpful oh yeah

32:03

yeah having a coach to hold you accountable people are four times more likely to to stick with an exercise

32:09

program when you have somebody to hold you accountable yep and there's a lot of great coaches out there i know we have two health and

32:15

wellness coaches here tony and liz who are amazing and sometimes it goes back to mindset too you know we have dr dan

32:22

gilman here a psychologist who's great and she actually specializes with chronic pain and sometimes there's a

32:27

mindset of chronic pain that people you know can't kind of get up and move and so i i just wanted to bring that up

32:33

because you know there was a recent article in one of the major medical journals about arthritis and osteoarthritis and how you know we know

32:40

that this is treated a lot of times with chronic tylenol or nsaids and things like that which can actually make pain

32:46

you know there's a short-term gain of reducing symptoms but a long-term you know even a reduction in outcomes or

32:52

rather worsening of the outcomes when that happens so this study actually showed that the best treatment for

32:58

arthritis was movement was literally walking and the thing you said to keep those joints lubricated

33:04

and so it's kind of interesting that um a lot of times you know people are like well i can't really move with chronic

33:09

pain but movement might be the best thing for them if done you know well and safely and in a professionally

33:15

supervised way absolutely yes so and then again if you

33:21

for example write this in your hands you can just start with just open going slow right open them up right so a lot of

33:27

times when you're not moving it at all that's how they stiffen up you start to get these different issues so always

33:32

keep moving never stop um that's just that's just the worst thing that we can that we can that we can do um like um i

33:40

read us an article the other day i was just saying that um how better rest is probably one of the the worst things

33:45

that you can do for your body and the reason is because you're not interacting with gravity right so like we're always

33:50

resisting gravity if i'm sitting up right now gravity is acting upon me right pulling me down to the center of the earth

33:55

and so i need to resist gravity right if i raise my arm i'm going against gravity and so

34:01

and so if i'm just laying down all day or just being sedentary so then it's like those muscles just just atrophy um

34:08

so i know like astronauts when they come back from space um a lot of times again they've lost like so much muscle mass

34:14

because they don't have they don't interact with gravity um while they're up there so it's important to get up get

34:20

your torso up and resist gravity and and move

34:25

and and for the listeners out there and for all of us you know i think that one of the one of the uh purposes of this

34:31

podcast is also to transform the consciousness around health and wellness and so we're talking about work and

34:37

we're talking about like sitting and we're talking about standing but then how can we bake movement in to our day

34:43

so that we just do it by default with that even without cell phone reminders or computer reminders i'd love to hear

34:48

thoughts about how to kind of by default increase movement throughout the day you know maybe maybe we all need to become

34:54

uh physical therapists and ptas like you and hisa you know we can then we're moving you know all the time but a lot

35:00

of us have jobs that sort of by default have a lot of sedentary or a lot of things we're not moving but i know for

35:06

me for instance sometimes i'll be you know with patients on zoom or something and i'll you know i'll realize oh i need

35:12

to i could stand during my visit or i could i could even like do some squats with them and like i could demonstrate

35:18

that and that's actually helping the patient and myself too

35:23

absolutely yes so find ways you can march in place so again if you're on a zoom call you can just stand up and

35:29

march in place while you're on that call you can stand up and just do some shoulder rolls right you can again if you have just a telephone call maybe go

35:35

out and take the call while you're walking so it's just those little things that you can do to increase and that obviously everyone knows um little

35:42

things like parking farther right and and then so you can walk a little bit um if you're if you're at a grocery store

35:48

movement let's let's make movement the default not the exception is that right yes i like that yes yes

35:55

um but yeah definitely it's i know it's easy for me to tell people that but again once you get

36:00

started to work when you're stressed out and you're going on going and you're locked in again before you know it the

36:06

whole morning when you didn't sit so i definitely would recommend getting something to remind you the people who

36:11

are who are best with it again you have some type of alert um because it's just you you just get away from it

36:17

so easily so it's important to have something to remind you now what now mia what is the

36:23

relationship between movement and activating those bones and muscles so that we can have good

36:28

structure and then get really good biological function and breath work what's the relation between movement of

36:34

breath work i'm wondering about that because you what you just said it just came to mind you know we're kind of go go going

36:40

all the time right and then and then we might be forgetting to breathe and then of course if we forget to breathe we

36:45

forget to move so i'd love to hear your thoughts on that connection yeah i'm so i'm really big on breath

36:51

work i actually took a full weekend seminar over 15 hours just when like the importance of breathing um so breath

36:57

work for chronic pain right breath work for um just like while you're stretching

37:03

that helps to kind of like let the muscles like relax better um and if i

37:08

get too technical into it but like when you do like deep breathing through your diaphragm it activates your vagus nerve which calms down your organs and all

37:14

these other things right and then um gets you out of that fight-or-flight state right so we're always kind of in

37:20

that sympathetic state where like we're always kind of flared up shallow breathing through your chest especially during the work day if you have a high

37:26

stress job your shallow breathing through your chest it's like you're really tense um but like and these are

37:31

the time that you actually need to breathe the most just because one you need to get that oxygen to your brain

37:36

oxygen to every cell in your body so you want to you want to take those deep deep breathing not only for the oxygen

37:42

but also to calm down your sympathetic nervous system activate that parasympathetic nervous system um so

37:47

like on my laptop right here i have a sticky note that just says just breathe right so all throughout the day i'm

37:53

getting that reminder especially when i'm stressed or feeling overwhelmed i just stop for a second take some deep breaths

37:58

um like into my nose i hold and out through my mouth just take that that couple of minutes and i feel so much

38:04

better afterwards um so i think i can't stress the importance of like just being

38:09

mindful of your breathing during the day it's so so so important and it's something i think that people don't just

38:15

don't do enough yeah i agree and and we know that you know breathing activates like you said

38:21

that lower third of the lungs and it activates like 50 more oxygen when you take that big expansion the diaphragm

38:28

when you um yeah i guess when you uh you know inhale exhale and that diaphragm is going up and down a lot more when you're taking

38:35

those deep breaths what do you what do you think about the um relationship between while we're doing say

38:41

intentional quote-unquote exercise or movement and breathing we know for instance that exercise will

38:46

activate the you know blood pressure will go up heart rate will go up we're going to get that adrenaline surging the

38:51

muscles are firing and all that um how should we breathe when we move and in other words should we do deep breathing

38:57

is there another type of breathing there yeah so it's important to understand that

39:02

when we like the human body is so amazing right so like when you're walking or you're doing certain

39:07

exercises your body naturally starts to breathe harder because your body's saying i need more oxygen to complete

39:13

this task right so that's why naturally your body starts to breathe that's that's literally why we breathe harder like our

39:19

heart starts to beat faster your body's saying i need more more more oxygen to meet these demands

39:25

that would let that uh that of my body right so so so that's why it's important that that

39:31

exercise is somewhat stressful to the body right so like if you're exercising it's completely comfortable you're not

39:37

gonna get a whole lot of gain right so you need your body needs to be able to say like okay in my day-to-day life like

39:43

that's why you want to add that good stress like to your lungs let your lungs and heart work a little bit so walk at a

39:48

pace or exercise at a pace that's your heart that is a little bit uncomfortable so you want to become comfortable being

39:54

uncomfortable because what happens is your body says okay um and it's called the law of imposed domain so you impose

39:59

these demands on your body and then your body says like responds to those demands by saying i need to be able to to to

40:06

lift more weight so i'm going to get stronger right you if you're doing if i'm doing bicep curls and taking it out

40:13

of what i normally would lift right so if i could normally do this but now i load a 20 pound weight and i'm curling

40:19

that 20 pound weight and now my body's gonna say i need to be on a day-to-day basis i need to be able to curl a 20 pound weight so like you're going to

40:25

break apart that muscle and then when your body sleeps you get good sleep and you recover that muscle grows back

40:30

stronger but your body goes back more resilient and so forth so it's important to understand that when you exercise it

40:37

should be a little bit um it should be a little bit stressful right like good stress on your body is

40:43

always taking you past your comfort zone the strength training whether it's the cardio um and so you shouldn't need to

40:49

like if you're doing your cardio you you want to be able to breathe a little bit harder if it because a lot of times when

40:54

people when they start to do exercise as soon as they start to breathe harder they stop when that's actually what you want to go into now obviously down this

41:01

like of this you also want to be safe again to make sure that anytime you start a good exercise program that you

41:07

that you have a strong heart that you're cleared by your doctor in order to to do these things because you do want it

41:12

again it is going to be somewhat strenuous on your on your systems um but you yeah but you do want it to be

41:18

uncomfortable when you exercise so i thought of something and it could be funny or not but uh this idea of no work

41:25

from movement no perks for movement right no perks what do you think

41:30

so i mean you're essentially trying to work when you move and not just like be at the status quo because you're really

41:36

trying to build that cardio respiratory fitness increase oxygen capacity increase the muscle mass but you're not going to do

41:43

that by doing the same thing that you're doing you know over and over um

41:48

so yeah no work no perks yeah i like that yeah or people always say kind of like no pain no gain all

41:55

that type of stuff too yep um so definitely it should be uncomfortable right so um and definitely whenever that

42:02

when you say no pain no gain is an important understanding that like like like if you should never like i always tell my patients you never want to

42:09

understand good pain versus bad pain right you never like if i work out the next day um if i do a bunch of pull-ups

42:15

or chest press like i want my muscles to be a little bit sore that that's how i know i've really worked it but you never

42:20

want joint pain okay right so like so it's okay for your thighs to be a little sore your butt muscles all these muscles

42:26

but you never want your your elbow and your knee i never like shoulder pain i never like neck pain i never like knee

42:32

pain hip so you never want joint pain but you do want some if you have some muscle soreness that's okay so

42:38

understand good good fatigue and like kind of good pain versus back pain okay so the joints versus muscles is

42:45

important there got it um just just going on the lungs of that

42:50

um do you recommend any sort of like hydration or nutrition post movement if someone is taking a break

42:56

during the work day or if they're just kind of at home trying to keep active whether or not they're quite working or

43:02

not what are the what are the some of the key things that you recommend there in terms of sort of optimal

43:07

optimal uh nutrition or hydration i think post post some sort of movement

43:14

yeah so so i'm not a uh i'm not a nutritionist so with i can't get too deep into that but like for me um like

43:20

you want to make sure you're drinking a ton of water during the day right so for those who are listening uh hopefully you

43:26

have you always have like a tall water bottle at your station so i always encourage everyone to have like water at the station yep awesome yup so yeah you

43:33

want to encourage yourself to drink water stay hydrated throughout the work day so always we always drink water

43:39

especially if you're working from home you have no excuse to not be drinking a lot of water so stay hydrated it's good for your brain

43:46

it's good for every cell in your body so stay hydrated especially days that you're going to work out if you drink a lot of water in those days you'll notice

43:51

you have more energy um so yeah so important that makes you drinking water now um post workout like i like to do

43:58

smoothies um i'm big on smoothies like protein shakes i try to do i try to stay away from from anything dairy so i'll do

44:05

a vegan protein powder i i do a lot of them i really only do fish um

44:11

but outside of that i don't really do like any dairy or whey so for those who get like drink ray protein like that is

44:17

still like kind of milk derivative so um so that's just my preference uh i know some people actually have to have dairy

44:24

for the nutritional needs uh and so forth but um so yeah so i like protein every single day i uh i do a smoothie

44:32

with um i which this is a little hack so what you can do um if you have like a little blender i have a big bag of mixed

44:39

frozen fruit right that's all i do is just grab a handful of fruit i throw it in a blender i grab a handful of spinach i throw it in a blender and i put in

44:46

that blended with water so that way um i get my fruits and i get my vegetables and sometimes i'll throw some like

44:51

benefit extra fiber in there too and i drink it every day i drink a smoothie i think i only missed three days all of

44:57

last year are you adding in the protein powder to the smoothie as well or yeah sometimes um

45:03

i don't know like like there's different recipes i don't really like the taste so much

45:09

like a lot of times i'll do it separate like i'll do like the the protein smoothie and then i'll do like a fruit smoothie because i don't really like it

45:16

and it makes the color weird too when you when you put protein powder in yeah yeah so i don't really the only time

45:21

i'll do the protein powder with my smoothies if i'm doing like peanut butter banana and then i'll do like a vanilla protein powder like if i'm doing

45:28

fruit any other fruits like for me i don't really like it but there's a lot of recipes online find a recipe that uh

45:34

that you like and uh but yeah for daily smoothies are really really good to uh to get a lot of those fruits and

45:39

vegetables you can just drink it and you get a lot of those same benefits um and when i do my smoothies i probably put a

45:44

whole salad worth of spinach like in that and i can consume it so easily because i'm drinking it but i put a

45:50

whole salad worth of spinach in there and of course and and of course you need the the foods

45:56

that are high in dietary nitrates like spinach to increase the nitric oxide which is going to help circulation

46:02

it's going to help get that blood flow to the muscles and and the bones you know so i think that that we know

46:08

that everything is related to sleep the mindset the community of course movement

46:14

and then nutrition and everything everything is all related here and but we know that really important you know

46:20

today thank you so much emil for coming on talking about structural health bone and joint health ergonomic health

46:26

we have a closing question that's a little bit more kind of one of these uh could be more of

46:31

a fun question but uh what what are things that you do um if you don't mind uh sharing with us

46:37

that that you kind of that center you in life and that bring you joy both you know i guess physically emotionally

46:43

mentally spiritually that's a great question so to my morning routine every morning i wake up um

46:50

and the first thing i do i save my gratitude right and i say all the things that i'm grateful for my daughter my

46:56

health both my parents still being alive um the ability to serve others um like i

47:02

genuinely enjoy i love what i do um and i love a lot of people who wake up and they're miserable every day i don't have

47:08

that feeling um so i do that um i do my pull-ups i have a pull-up bar at home so i do my pull-ups to kind of get my body

47:14

up i go my balcony and i do some deep breathing i do my meditation i visualize my day like i visualize how i want my

47:21

interactions to be i visualize for example this this this podcast right that visualize that i want to be a light

47:26

um to the world i want to shine and um for those around me i want to serve and

47:32

um like i visualize like like i don't really get like i do podcasts like this

47:37

uh and when i do classes and things like that i don't really get nervous because instead of thinking about um

47:43

like what i don't want to happen i visualize what i want to happen i visualize how do i want people to feel

47:49

when they leave my like that interaction with me right i visualize like what's

47:54

the biggest takeaway so i always kind of think about what i want to happen as opposed to what i don't so i visualize my whole day in the morning while i do

48:01

my deep breathing sometimes i'll do some morning yoga or morning stretches so just something to kind of get my body

48:07

just like kind of calm um and then and then i start my day i make my to-do list and then i just try

48:12

to check it off as i um two out of day um as far as like for movement as well like um i have a like i said i have a

48:20

three-year-old daughter which is it's great because she loves uh she loves she's very athletic and so she loves to

48:26

move so like we always go outside so that's our thing man it's uh we'll go like hiking we'll go

48:32

and that's uh doctor he's just daughter too like sometimes we'll get them together to do stuff but like we we kick their butts man

48:38

so it's great because i could i couldn't do probably a bunch of tea parties all day so that's great i love that she

48:44

loves to move so we'll go out to the track we'll go we'll play soccer we'll play basketball play baseball we'll go

48:49

we'll go and do walking pass we'll ride our scooters so that's my way of just getting movement um so yeah man get

48:56

creative find ways that you that you that you that you uh find things you love to do but that's that's probably

49:01

how i move most yeah and and i just want to share you know what just echo what you said um i

49:06

also have a morning routine i really think that movement is the foundation of that you know getting getting everything

49:12

moving you're really moving physically but you're also kind of moving the emotions and the mind and spirit when

49:18

you do that so we have to get beyond the mind body split which is actually from descartes descartes i think back in the

49:25

1500s right this is all about mind-body connection that's what integrative health is about but then you mentioned

49:31

hisa so just to mention two to you that we're also taco buddies we like to sometimes go out and eat some tacos so i

49:37

have to ask you this as another fun question if you're at a taco bar and you could have unlimited toppings whatever

49:43

you want to put on it what what are your kind of three main ingredients in that taco never asked anyone on that podcast

49:51

so so i like so again i mostly do fish so i like first tacos

49:56

um uh i had a really good fish taco today normally i i try to avoid dairy

50:02

but you can do like a slaw like jalapenos uh slaw and then what else do they put on fish

50:08

tacos so like jalapenos they do like us like especially little slaw like red onions

50:14

and then like some some hot sauce like i like a lot of spices there's actually that chain around here literally called fish taco have you eaten at that before

50:21

yeah yeah it's good it's good great well thank you so much emil for coming on a lot of topics we discovered

50:27

today and um let's talk about just how listeners can learn more about you and work with you it's awesome yeah so

50:34

obviously again i'm a clinician at a cih so i work closely with with dr hisa so definitely if you are a cis member

50:41

absolutely you can uh you can contact me or reach me through the i guess through the front desk and then if you're not um

50:46

you can always contact me you can do elevationhealthergo.com that is my my website uh my facebook

50:53

it's elevation health um in ergonomics or i think i have like the like the

50:59

short thing is ehe underscore movement for instagram and facebook ehe underscore

51:05

movement so like my whole brain is movement right so it's like encouraging people to move more that's it so it's

51:12

very very important to move more so so ehe underscore movement elevation health ergo my what my email is elevation

51:19

health yahoo.com so yeah i'd love to uh to help please let me know if you have any other questions that i didn't get to

51:24

help today thank you awesome thank you so much emil move motion is the new lotion as we said

51:30

a couple times here and uh we'll chat soon thank you so much thanks so much for the opportunity dr juan

51:38

thank you for taking the time to listen to us today if you enjoyed this conversation please take a moment to leave this review it helps our podcast

51:45

to reach more listeners don't forget to subscribe so you don't miss our next episodes and conversations

51:50

and thank you so much again for being with us

Chronic PainAndrew Wong