Transcript EP 292 – Future-Proof Your Body and Relieve Chronic Pain in 12 Simple Movements with Vinh Pham

Transcript EP 292 – Future-Proof Your Body and Relieve Chronic Pain in 12 Simple Movements with Vinh Pham

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Dr. Taz: Welcome back, everyone. Welcome back to another episode of Super Woman Wellness where we are determined to bring you back to your super-powered self. And joining me today is a very special guest talking about our posture, as I slouch as I speak. I have with me Vinh Pham, author of Sit Up Straight: Futureproof your body against chronic pain with 12 simple movements. He’s a licensed physical therapist with over a decade of experience, working with industry-leading health and wellness brands, and treating top athletes, celebrities, and entrepreneurs. He’s the founder of Myodetox, a group of design-forward manual therapy clinics that are re-imagining the traditional therapy and rehab experience. Using his unique system of manual therapy, Vinh has daily educational videos that help millions of people learn how to take care of their bodies.

Dr. Taz: Welcome to the show.

Vinh Pham: Thank you for having me, Dr. Taz.

Dr. Taz: Yes, definitely. And thanks for putting up with my slightly stuttering voice with this new InBrace device I have. Always a challenge. But you know what? We’re here to deliver information and really get people to learn about the little things they can do in their lives that make a big difference.

Dr. Taz: What inspired you to tackle this particular topic about how we sit and how it’s related to chronic pain?

Vinh Pham: I think everything in my life has always been about educating people about how their body works. I always thought, I always truly believed, that the only thing you truly own is your body, and you should treat it as such in terms of treating it like a temple, maintaining it on a regular basis, optimizing it, and things like that. But I felt like throughout life, as I’ve grown older and older, I’ve realized that a lot of people don’t take care of their body. I’m 38-years-old, and a lot of my friends from back in high school, and stuff like that, you can literally see the people who have taken care of themselves, and people who haven’t taken care of themselves, and the difference is remarkable.

Dr. Taz: Oh, my gosh. As people hit 40, I feel like it’s a sifter. You can tell who’s been health conscious and who has not. It’s like night and day what 40, and even 50, even 60, any of those ages, what those ages can look like.

Vinh Pham: Absolutely. It’s night and day. And then in that process of looking at things like that in that way, I’ve realized that no one really has a routine to take care of their body. We have a routine when it comes to our skin, when it comes to our hair. When it comes to our teeth it’s like brush and floss. When it comes to your skin it’s a moisturizer/cleanser. When it comes to your hair it’s shampoo/conditioner. But what do we do on a daily basis for our knees, for our ankles, for our back, for our neck? Nothing.

Dr. Taz: That’s so true. We just take them for granted, right?

Vinh Pham: Yes.

Dr. Taz: Our poor joints. We’re taking them all for granted.

Vinh Pham: Exactly. So there’s no joint hygiene routine, postural hygiene routine, and that’s what inspired me to write the book. And then obviously I use the word Sit Up Straight because in our current culture sitting is so prevalent, especially obviously in Western culture sitting is rampant, and I chose that topic because I thought it was relevant to relate a bigger message, which is essentially take care of your whole body. Obviously, it’s not only about sitting.

Dr. Taz: Yeah. I was fascinated in reading your bio. I know you’re a physical therapist, but Myodetox, the manual therapy clinics that you are talking about, what type of manual therapies are you doing in those clinics, and how do they address the everyday issues that your clients are experiencing?

Vinh Pham: If you think of the typical physical therapy clinics, they’re very focused on being reactive, so they really only focus on pain, and the second part is they’re very localized in terms of how they view the body. You come in, you have a knee issue: they look at your knee, they help alleviate pain on your knee, and then they send you on your way.

Dr. Taz: Right.

Vinh Pham: Right? Versus the way that I treat, and everyone who works at Myodetox treats, is essentially you come in, and let’s say you have a knee issue, the first step is understanding what’s going on at your foot, what’s going on in your hip, what’s going on above and below the joint, and as well as how does all three of those joints basically communicate to each other and move together? And then once your knee pain is gone, what is the plan after that? No one really ever has a plan post-pain. They use that as their North Star, versus me it’s like, “Hey, how can we make your knee move even more efficiently? How do we make sure the pain never comes back?” That’s how we’re different at Myodetox.

Dr. Taz: God, I love that. Do you have a lot of men in the clinics?

Vinh Pham: Both men and women.

Dr. Taz: Just in dealing with my husband in particular, trying to get him in when he’s not in pain, but past the point of pain, has continued to be a challenge. He’s a dentist, so he gets a lot of this neck and shoulder type pain. It’s like, “Can I book the appointment for you?” “No, no. I got it. I got it.” Here’s July and nothing has changed.

Vinh Pham: Funny enough, a lot of men that come in, come in because their girlfriends or wives booked their appointment. That’s actually so funny that you say that because it’s actually so true because guys… Go ahead.

Dr. Taz: No, I was going to say it’s something I live with. And then honestly, even in my clinics, a lot of times the wives and girlfriends and sisters and daughters are taking the men into… Why is that? What do you think is happening there?

Vinh Pham: I think in general men are just taught to endure, in general, either when it comes to pop culture, in movies, or in Disney movies. All these things, it starts creating this whole idea that men should just walk it off, but I think that’s not the smartest thing to do.

Dr. Taz: No. And it results in injury, right?

Vinh Pham: Totally.

Dr. Taz: I mean it results in long-term injury.

Vinh Pham: Yeah. If you want to be there in the long run to protect your family, if you want longevity in your life, you’ve got to take care of yourself. You’ve got to put your mask on before you take care of other people on the plane. That’s how it works.

Dr. Taz: Totally. So for all the women, and hopefully there’s some men listening to the show, get your loved ones into whatever appointments they need. We’re talking about physical therapy today. But trust me, I live first-hand with somebody who really needs it, but I’m still fighting that fight to get them in. I think in this scenario it’s okay for us to be nags.

Dr. Taz: But let’s talk about your book, Sit Up Straight. Because I think the inspiration, from what I understand, of writing this book, really came from the pandemic and from COVID. What were you seeing during the pandemic? How was it affecting people in terms of how they took care of their bodies and what they were doing for themselves?

Vinh Pham: I think the stat is on average people sit anywhere between like 13 to 15 hours a day, and that’s just in general. And then with COVID, people were sitting upwards to 17 hours a day.

Dr. Taz: Wow.

Vinh Pham: Right? So that’s including office hours, obviously working from home, working at their desk, kitchen table, or also from the couch. And now it’s like you’re going from your kitchen table in all these weird positions, going like this, and then you relax after a day of work and you go on the couch, and you sit all contorted with your loved ones. And then you also didn’t have an outlet for physical activity during that time because your usual volleyball runs or soccer runs, or whatever it is that you like to do, you’re confined in your spaces, so that definitely showed up in the clinics where everyone was having back pain and neck pain like crazy. And then we were lucky enough to be open during COVID because we’re essential services, so we got to see it. We were almost the only movement someone would get during the day.

Dr. Taz: Wow.

Vinh Pham: Walking from their house to the car to the clinic, and then doing exercise at the clinic, and they’re like, “Oh, my God. This feels so good,” and I’m like, “Yeah. Well, you just need to move in general.” So that’s what I saw during COVID, and I saw it as an opportunity to… Now that everyone is at the peak of awareness in terms of like, “Oh, man. I really need to take care of all these things,” not only when it comes to your body… and in terms of life too, a lot of people started having life realizations during COVID… and I just thought the book was appropriate, and then that’s how it came about.

Dr. Taz: Gotcha. And I love how you talk about a joint wellness plan, just like we have a skin and hair wellness plan, a nail wellness plan, all these other things. What are the key elements of that type of plan?

Vinh Pham: It needs to be daily, if possible, but regular if not daily, and it’s very simple. It’ll take anywhere between 5-15 minutes to essentially just have your body articulate through its full range of motion. And then as you build more and more comfort with these movements, things just get easier, and it’s really that simple. And your body essentially just needs to experience what it doesn’t experience. So if, for example, in your daily life you’re always turning your neck to the left like this, over time your brain starts losing the ability to turn your neck to the right well. Simple as that. If you’re doing 17 hours of this, in a perfect world you would have 17 hours of this. But in our world, it’s like your spine experiences flexion for 17 hours sitting down, and then you lie down, and maybe get a little bit… but you’re still flexed because maybe your bed is soft, so really your lumbar spine is basically… your lower back is flexed forever.

Dr. Taz: Right.

Vinh Pham: You know? And all of a sudden you decide to extend, because you’ve got to go pick up something, or you’re playing basketball and you’ve got to reach, and all of a sudden your back just goes, “Hey, listen. We can’t do that,” and then your whole musculature goes into spasm.

Dr. Taz: When we started the show, I was sharing with you how I’ve got dead butt syndrome, which is basically where the gluteal area is super weak, which is shocking to me because I do yoga, I walk, I do weights, but I guess I’m not… Because I am sitting a lot, I have a very sitting-friendly job, there are muscles I haven’t reached or I haven’t gotten to with my routine. So this 5-10 minutes a day, is this a whole body movement? Is it once a day or twice a day? What do we do, for those of us that sit, what are maybe three or four things we could be doing to make sure we don’t get locked into this muscle memory where we’re not using the layers of muscles underneath the ones that we commonly know?

Vinh Pham: The way that I designed the routine is essentially 12 exercises that you can run through if you want to hit everything. If you don’t want to think about it, you want to hit everything, just run through the whole routine, it’ll take you roughly 20 minutes. But if you want to get specific, it really depends on what your issue or injury is. Some exercises are more focused on the spine. Some exercises are more focused on your foot. It varies back and forth. If you were thinking about, to the average listener, that these two, three exercises would fit for everybody, I would say the number one exercise I would give out of everything is probably the gears exercise, which is the first exercise in the book, which is essentially about articulating your spine, and understanding how all these… your arms and your legs, for example… all play a role in mobilizing your spine.

Vinh Pham: And then simple enough is… You want me to go through it right now or…

Dr. Taz: Yeah. I was going to say. Let’s take a look at it.

Vinh Pham: Simply, let’s just start first understanding this is your thoracic spine, so the middle of your back. Right?

Dr. Taz: Uh-huh.

Vinh Pham: Let me do it from a sitting position. You’re here like this, and you basically just want to see… If you slouch like this normally, how about if you just straightened up, and literally just going back and forth between these two positions will make you start to understand, “Oh, what do I feel in my body? Am I tight more on the left side of my lower back? Am I more tight on the right side of my lower back? Or is it more like the middle of my spine? Or is this bothering my neck? What do I feel?” Dr. Taz, what do you feel when you’re doing this? Do you feel any tightness anywhere or any…

Dr. Taz: I feel a little bit in my lower back.

Vinh Pham: Lower back. Okay. You see already we’re starting to see that’s definitely an area of focus that you want to work on for this exercise. The next step is you’re going to take your hands and you’re going to turn them out. Put them to your side like this. And as you’re them out, notice what happens to your back.

Dr. Taz: Yeah. Especially the right, this right shoulder, right area.

Vinh Pham: Yeah. So you have tightness in your right shoulder. You might have tightness in your shoulder. You might notice that as you’re turning your arms out like this, it’s driving your spine to extend even further.

Dr. Taz: Yeah.

Vinh Pham: Right? And then the reverse is you would basically bring your arms forward like this, and have them face like this. As you’re doing that, you’ll notice that it’s going to feed into spinal flexion, so your spine is going to start bending forward a little bit. And basically you’re just going like that, and then you’re reversing it, and opening it. Right. Exactly. From the side it looks like this. Essentially, you’re just brushing and flossing your spine. You’re just flossing it out, helping to experience ranges of motion it hasn’t in a while. And then you start noticing in your case, for example, “Hey, listen. Something’s going on with my right shoulder. Something’s going on with my lower back. Oh, I definitely need to help boil this whole situation up.”

Dr. Taz: Yeah. For those of you that listen and don’t actually watch the podcast, this would be a great video to watch because Vinh is actually showing me some of these exercises. I’m just thinking of all of us sitting in the car, or in the carpool line, or maybe at our office jobs, or at our computer, or even me talking to a patient, just these simple things that we’re doing throughout the day I know can make a really big difference.

Dr. Taz: Let’s do another one. What about tech neck?

Vinh Pham: Tech neck.

Dr. Taz: One of the things that’s super interesting in practice, we do a lot of Eastern medicine and practice too, so we’ll do the scanning on folks: and every patient, I kid do not, it comes back on the Chinese medical scan, “Has inflammation at C7 and T1,” so that’s a tech neck. I think it’s all of us doing this whole phone routine. What’s the solution to that? What’s the solution to avoiding tech neck, and elongating our neck, and keeping us up when we’re always looking down?

Vinh Pham: There’s a few solutions, but simply the first exercise will for sure help you a lot because that’s going to help you extend through the middle part of your back, and it’ll alleviate tension at C7-T1. One of the main reasons people have tech neck is because they essentially use more of their upper cervical, so the upper part of their neck versus the lower part of their neck. Just to show you from here, people now will start to rotate and look up from here, versus having any motion from here, from the bottom.

Vinh Pham: And then this next exercise that I’m about to show you, you guys can Google it at home too, it’s really easy to find, it’s called a chin tuck, which essentially you want to sit up straight like this with good posture. And then from here, you’re basically going to… Someone’s trying to touch your chin, and you’re basically just retracting, moving away from it, and you’re essentially going to give yourself a double chin. And then while you’re doing this, you’re going to start feeling a huge stretch in the back of your neck. All of this is going to feel like it’s opening.

Dr. Taz: This is the chin tuck?

Vinh Pham: Chin tuck. Yeah. Do you feel that, Dr. Taz?

Dr. Taz: Yeah.

Vinh Pham: Amazing. And just going to relax, and you’re going to bring it again, and you’re going to hold it for a second or two.

Dr. Taz: It almost hurts.

Vinh Pham: Yes. It does hurt if you haven’t done it in a while. Yes. Pain is gain.

Dr. Taz: Oh, man.

Vinh Pham: Yeah.

Dr. Taz: I can’t believe we’re all looking down as much as we are. And then is that same motion what’s causing TMJ?

Vinh Pham: No, not necessarily. But it’s just a lot of times when people have neck issues, it definitely starts affecting how your body position is in terms of your head and your jaw, and then you might end up chewing a certain way, everything is misaligned. For example, if you’re side bent like this, naturally when you put food in your mouth it’s going to go towards the right.

Dr. Taz: Got it. Are you seeing a lot of TMJ in clinic?

Vinh Pham: Yes. I do see a lot of TMJ. We see TMJ as well for sure.

Dr. Taz: Are there exercises that help? Because I feel like that’s an epidemic. I feel everyone I touch is inflamed. So are there exercises that we can do to help relax that area?

Vinh Pham: Yeah, absolutely. A simple one is you’re basically just taking your hands and you’re basically just… You would be touching here, right here on your cheek, from the angle of your jaw here, and you’re basically pushing up. This muscle’s called a masseter, and you can go upward.

Dr. Taz: I wish you could watch me, guys. This is probably hilarious, but also painful.

Vinh Pham: Yeah. You can also go down as well if you hold your head like this and just push down like this.

Dr. Taz: I’m doing it right?

Vinh Pham: Yeah. You’re doing it right. And just push it down.

Dr. Taz: Ahh.

Vinh Pham: Yeah. There you go. That would definitely help you relax your joints.

Dr. Taz: Going up and then pushing down.

Vinh Pham: Yeah.

Dr. Taz: Gotcha. Oh, my goodness. These are so good and you can do these anywhere. That’s so good.

Vinh Pham: Anywhere. At home, in the car, hanging out.

Dr. Taz: Do you feel like people should go to a physical therapist monthly? What kind of routine should folks have, do you think?

Vinh Pham: I think that in a perfect world we would be similar to a dentist, as in if you have a cavity you would go see us. But currently, in the current state of the world, people are coming to see me and literally I just go, “You should brush your teeth.” It’s essentially what I tell them. A lot of these exercises in the book are things that therapists will be teaching you when you go see them at my clinics, for example. But to me, this should be almost common knowledge, and you should only go see me for something very complicated, such as a sleepy glute, or something that’s a little bit more complex is what you should come see me. But a lot of people come in and they’re just like, “Hey, can you clean my car?” I’m like-

Dr. Taz: “Not in one session.” Right.

Vinh Pham: Yeah. But generally, in terms of prescription, I would say if you have an injury, you’re seeing someone anywhere between three to four sessions for a minor issue, moderate issue is between five and eight, and then 15-plus is more chronic issues that have just been forever. In a perfect world, you’re seeing a physical therapist, doing our methodology, you’re probably seeing them once a month for half an hour to an hour, just to check in, “How’s your movement this week? What are your movement goals?” Something like that.

Dr. Taz: I think that would be so helpful because one of the things we all see in practice over and over again is everyone wants to power through, right? Their jaw might hurt, their neck might hurt. My husband, right? Neck might hurt, shoulders might hurt, hips might hurt, but they’re going to ignore them until there’s a major issue. What are maybe the top five preventable physical therapy joint issues that you see in your practice?

Vinh Pham: I would say almost everything is preventable, to be honest with you. If it becomes a chronic pain issue, it’s super preventable. It’s just you have to be aware of it, and you just have to do the right exercises for it. It’s actually really not complicated. It’s like saying, “How do you prevent your teeth from falling out?”

Dr. Taz: Gotcha. So movement. Movement, movement, movement.

Vinh Pham: Movement, movement, movement. Movement that your body does not experience often. How do I build your movement vocabulary the same way I would build your actual vocabulary? The more words you know how to use, the more eloquent you are when you’re speaking. The more movements that I teach your body, the more you’re able to troubleshoot when something’s stuck in the back of your car, and you try to grab it, and then you know exactly how to do it. But if you’re not ready for it, this is a movement you’ve never really been accustomed to, all of a sudden, “Oh, my shoulder just blew out.”

Dr. Taz: Such helpful information. I’m thinking about how we obviously need to incorporate this stuff into our lives day in, day out. How much do you have to educate folks on the connection between their muscle pain and not just their posture, but also inflammation and some of these other ideas? Do patients talk about that very much or…

Vinh Pham: Yeah. For sure. As we all know, pain is multifactorial. There’s nutrition, there’s sleep, there’s stress. There’s so many things that, all piled together, could create like, “Hey, listen. This is why you’re feeling this pain.” Obviously, from a physical therapist perspective, we mainly focus on the biomechanics MSK part of it, musculoskeletal part of it, but we are definitely very aware of all the other things as well, all the factors as well. But I think overall as a profession we’re not well-trained, to be quite honest with you, for all these auxiliary things.

Dr. Taz: And let’s say somebody’s a little bit further down the health spectrum and they have obesity issues, or some of those types of issues? Same exercises apply? These are things they could do as well?

Vinh Pham: Yeah, of course. Same exercises apply, but I would also say that you need to get your weight under control, you need to get your nutrition under control. Because I can feed you all the greatest exercise, but if you keep eating at McDonald’s…

Dr. Taz: It’s not going to work.

Vinh Pham: It’s not going to work. Right?

Dr. Taz: Right.

Vinh Pham: To me, the best approach to physical therapy and physical health in general is just common sense.

Dr. Taz: Yeah. I love you’re like, “It’s easy. It’s like brushing and flossing. Move your joints.”

Vinh Pham: Yeah. The hard part is just convincing people to care about it; that’s really what it comes out to. How do you explain to someone that if they don’t take care of their body, when they’re going to be… Let’s say someone’s 22-years-old, how do you explain to them that at 55-years-old or 60-years-old you might not be able to play with your children or grandchildren? You know what I mean? You will actually not be able to move because of the way you’re dead-lifting right now. And you want to impress everyone at the gym and lift 400 pounds, but you don’t want to warm up, but you don’t think about this because this is so far out. But when it comes to your teeth, for example: if you don’t brush your teeth, the ramifications of your teeth falling out in the long-term, you’re aware of it, but you don’t really even care that much. But the reason why you care is because your breath is going to smell, and you’re going to look a certain way, and someone’s going to tell you immediately that day. So the incentives line up where you go, “Oh, yeah. I’ve got to do this or else my wife’s going to leave me.” You know?

Dr. Taz: It’s so hard to motivate people when they can’t see it or feel it. Is there any scan or body scanning out there where it tells you these are the weaker muscles? I’m telling you I didn’t realize I wasn’t using my glutes effectively. I had no idea. So is there anything out there that you could preventively step into, and it’s like, “Hey, watch these muscles”?

Vinh Pham: Yeah. To tell the truth, I’m not really aware of anything that’s really consumer friendly, that’s easy to get to, that’s not like, “Hey, get into the scanners,” and it’s going to cost you $5000 to scan your whole body. But to me it’s as simple as teaching people to have, almost like a body awareness test. It’s exactly what I did with you. It’s like, “Hey, move your shoulder. What do you feel at this end range of motion?” “Oh, this one feels off versus this one.” The same way you would do a breath test like, “Does my breath smell bad?” Or look in the mirror and go, “Do you have something stuck in my teeth?” It’s the same equivalent. It’s just you have to be aware of it. For example, when you’re walking do you feel like your right foot and your left foot are striking the ground the same?

Dr. Taz: Absolutely not.

Vinh Pham: Yeah, exactly. But people don’t pay attention to that. They don’t even think about that. But if they start thinking about it and they start being like, “Oh, yeah. My right foot feels really off. Maybe that’s why I can’t activate my glute as much as my left glute, because my right foot doesn’t pronounce well.” I’m getting a little bit technical but my right foot doesn’t pronate well; and because it doesn’t pronate well, that whole chain of the ground… Sorry. The ground reaction force hits your foot, and all these articulations start up the chain, to start waking up your glute, it doesn’t happen because it just stops here, and the force doesn’t really transfer that way, because your foot doesn’t articulate with the ground properly. And if your foot doesn’t articulate with the ground properly, your glute actually can’t turn on, so that is the level of detail that you can go into when it comes to teaching somebody. But the first step is… It would be easier for me to say that if you come to see me and then you go, “My right foot is off,” but people don’t really come saying that. They just go, “This hurts,” or “This hurts,” and it’s not really nuanced. Then I have to do so much detective work.

Dr. Taz: To figure it out.

Vinh Pham: Yeah. To figure it out.

Dr. Taz: Gosh. I want a copy of your book. I’ll give it to my husband.

Vinh Pham: Yeah, yeah. I’m going to send you one.

Dr. Taz: Because he needs it for sure.

Vinh Pham: Yeah.

Dr. Taz: How can people find out about your work and what you do? What’s the best way for them to connect with you?

Vinh Pham: They can either go to Myodetox.com, M-Y-O-D-E-T-O-X.com. Or they can also follow me on Instagram, VinnieRehab, so V-I-N-N-I-E-R-E-H-A-B.

Dr. Taz: Perfect. All right. Well, thank you so much for joining me and educating us about joint and muscle awareness. It’s like brushing and flossing. We just need to make it a part of our routine habits. I love that analogy so much. So thank you.

Dr. Taz: And for everyone else, thank you for watching and listening to this episode of Super Woman Wellness. We’ll see you guys next time.

 

Dr. Taz Bhatia M.D.