EP155: "Stem Cell Physical Therapy: Rehab Protocol & Guidelines For Recovery Post Stem Cell Injections"

[00:00:00] Welcome all new listeners and welcome back to those who've heard my content in the past.

[00:00:03] If you're a physical therapist and you really want to maximize your outcomes and you are

[00:00:08] starting to see an interest in stem cell therapy and post rehabilitation and you are looking

[00:00:14] for the next best answer on how to help your patients stay more active after these procedures.

[00:00:21] This episode is perfect for you.

[00:00:29] Are you a motivated healthcare fitness professional?

[00:00:31] Are you looking to work with more athletes, become a sports specialist or even get a job

[00:00:34] in a sports setting so you can finally enjoy the career that you've always dreamed of.

[00:00:39] If so, you're in the right place.

[00:00:41] My name is Chris Garcia, physical therapist, business owner, entrepreneur and residency

[00:00:45] trained sports specialist.

[00:00:46] I've been fortunate to work in professional sports and travel around the world working

[00:00:49] with elite athletes throughout my career and I've learned a lot of lessons along

[00:00:53] the way.

[00:00:54] I created this podcast to share my experiences and give you everything you need to know

[00:00:58] to help you become a sports expert.

[00:01:00] Welcome to the Sports BT Academy.

[00:01:02] Thank you for everyone for being here.

[00:01:07] For those of you who are not on YouTube watching this podcast, we have two amazing humans

[00:01:12] that are with me today and thank you for the invitation.

[00:01:16] I have Scotty Nelson and Lola Drinker here and I am here today really to get

[00:01:23] an understanding on how we can help the planet, how can we help the patients

[00:01:28] that come to see you after STEM self therapy and ultimately what is it that you

[00:01:33] want physical therapists all over the country and world to know.

[00:01:36] That is my goal today so thank you guys for having me.

[00:01:38] I'm really excited to be part of this.

[00:01:41] You know, I think we've worked with Scotty.

[00:01:44] When did we first see you?

[00:01:46] It's been a few years.

[00:01:48] Yeah, it's been a few years now and it was right after.

[00:01:53] So I was the first person at the Cellular Performance Institute to get my discs injected.

[00:01:58] My business partner Francisco had already done something like 900-1 so I wasn't the

[00:02:03] guinea pig of the world by any means but the first person at our hospital to get it done

[00:02:09] and after I got the procedure done, Francisco and my doctors had really

[00:02:15] encouraged me to get physical therapy.

[00:02:19] It was, I broke my back in 2010.

[00:02:22] I got back surgery 2011.

[00:02:26] It was two years ago, almost three years ago now so it was about 10-11 years post-surgery.

[00:02:35] My surgery was not what I would consider successful.

[00:02:38] When I got my surgery they told me three months I'd be fine back in doing things.

[00:02:43] Took me eight months to be able to walk and then I did two years of physical therapy.

[00:02:48] I was a competitive jujitsu fighter before then for many years.

[00:02:51] So basically it took me almost three years to get back on the mat.

[00:02:56] Wow.

[00:02:57] And then that road was really, really painful.

[00:03:00] I ended up re-injuring my back actually down in Costa Rica at what is now heroes

[00:03:07] which was a non-profit that Lola helped work with and create to get the local kids there free jujitsu.

[00:03:14] I was there with Rafael Lovato.

[00:03:16] Felt a click in my back.

[00:03:18] I could not walk for eight days later the trip back and on that trip back it was like

[00:03:23] I have to give up jujitsu.

[00:03:24] It was super depressing for me.

[00:03:27] Fast forward about five, six years later I got the stem cells and now my back's like 100%

[00:03:34] a lot because of you guys.

[00:03:35] So you know what my schedule is hard for me to get into sports performance.

[00:03:40] But I was getting there once a week, once every two weeks with my back

[00:03:43] and I just saw what you guys were doing.

[00:03:45] First of all it's completely different than any other physical therapist I've ever been to

[00:03:49] especially on the level of caring your team has.

[00:03:52] But on the improvement between each time I was going back I was getting better and better.

[00:03:58] That's amazing.

[00:03:59] And so that's been a few years now.

[00:04:01] And now if you were one of the first ones here at CPI to get stem cells

[00:04:07] and you've had the therapy that was probably three or four years ago.

[00:04:12] And here you are today at a different level.

[00:04:14] You're seeing so many more patients with stem cells.

[00:04:17] How did you find your path into CPI in terms of now being part of growing this

[00:04:22] and helping people over the world?

[00:04:24] Sure.

[00:04:25] Well I found my path in here because of my business partner Ed Clay.

[00:04:29] I mean the guy's just a genius.

[00:04:31] And he had an experience with blowing out his knees

[00:04:35] that led him to look into alternative stuff.

[00:04:38] Something called Ibogaine which is for opiate addiction.

[00:04:43] After he was able to basically fix that in a matter of days his mother was actually

[00:04:48] in a really bad place because of rheumatoid arthritis.

[00:04:51] And the doctors had basically failed standard of care on her.

[00:04:54] Nothing had worked.

[00:04:56] And he found a treatment that was no longer legal in the United States

[00:04:59] that was available in Mexico.

[00:05:01] Chipsa Hospital had done a lot of that treatment

[00:05:04] and that started on the process.

[00:05:06] It had actually closed.

[00:05:07] It had been closed at that time I think for about a year.

[00:05:09] So he couldn't take his mom.

[00:05:11] So that started the process of what eventually became buying

[00:05:15] and reopening the hospital which was it had been closed I think for about 18 months.

[00:05:22] His mom's name is Regina.

[00:05:23] She was the second patient that we had.

[00:05:26] She came in a wheelchair and she left shortly after walking.

[00:05:29] She's been doing amazing ever since.

[00:05:31] That move Chipsa was originally a cancer hospital.

[00:05:35] So when we reopened it and brought the doctors back they wanted to do cancer again.

[00:05:40] And we started working in cellular therapies for cancer.

[00:05:43] We always knew we could do regenerative medicine.

[00:05:46] But really that's quite frankly easy compared to cellular therapy for cancer.

[00:05:51] Cancer is the hardest one of them all.

[00:05:54] And so as we got the cancer program going and we're happy with results

[00:05:58] and growing that we moved into the regenerative medicine.

[00:06:02] It really only became the Cellular Performance Institute instead of Chipsa

[00:06:07] because Google changed the rules on advertising stem cells

[00:06:11] and they shut down our Chipsa page

[00:06:14] and we couldn't run ads for cancer or anything like that.

[00:06:16] They listed us.

[00:06:18] So we said we got a shift and create a whole new company.

[00:06:22] Wow that's amazing.

[00:06:24] So I know Scotty's story a little how I mean it's great to have you on.

[00:06:28] How did you how are you part of this whole process?

[00:06:31] Great to be here.

[00:06:32] I mean that's also a long story.

[00:06:34] But I know Scotty and Ed from Jutsu Mastermind

[00:06:39] we were part of a decade maybe 11 years ago now.

[00:06:43] We're down with that now.

[00:06:44] Yeah maybe longer than that.

[00:06:46] And during the mastermind around that time was when the guys got the hospital

[00:06:52] and about a year after that in early 2018

[00:06:57] my dad was diagnosed with lung cancer in New York.

[00:07:01] So they gave him two weeks to live in New York.

[00:07:06] The tumor was 13 centimeters across this whole lung.

[00:07:10] Was it his hip bone collar bone

[00:07:13] and they said look we could try a palliative chemo

[00:07:16] and my dad is a Soviet guy who are from Uzbekistan

[00:07:20] so he was like doctor is authority doctors are like whatever they say goes

[00:07:26] and I've been a holistic health coach for 12 years now

[00:07:30] and he was like I don't want any of your voodoo medicine

[00:07:33] I'm gonna do what the doctor says.

[00:07:35] So it went to Sloan Kettering he got his chemo dose,

[00:07:39] ketruda and a platinum based chemo

[00:07:42] and in three days he couldn't walk

[00:07:45] and it was just getting so bad that they wouldn't do the second chemo round

[00:07:50] and I messaged Ed and I was like Ed these are the records

[00:07:55] and he said I don't think you can get him here

[00:07:57] because how are you gonna fly cross country

[00:08:01] and he said you just leave it up to the doctors

[00:08:03] if our doctors can say that you know that they can try just bring him

[00:08:09] and I brought him and it was the most amazing thing that happened to my family

[00:08:16] I'm getting first podcast so I'm gonna cry.

[00:08:21] Two weeks his tumor is down 40%

[00:08:26] from all the amazing treatments who did a chip so which gurson therapy cellular therapies

[00:08:31] he was one of the super responders who VG5000

[00:08:35] and a couple other things that we're doing

[00:08:38] and it was just I got my dad back you know he went from his death bed to thriving

[00:08:45] he went back to work full time

[00:08:48] and then a year later he had a heart attack that he didn't survive

[00:08:52] but he had an MRI the day before he passed

[00:08:56] he had only scar tissue left in his lung

[00:08:59] nothing else.

[00:09:00] So caught the heart issue you know I always

[00:09:05] think that in an alternate universe he would have made it

[00:09:09] but it was a year of another birthday another Christmas

[00:09:13] and other and everyday's gift right that's I think a lot of people

[00:09:18] just like with stem cells they're looking for the cure

[00:09:22] they're not thinking about the improvement in their quality of life

[00:09:26] the improvement in you know if you're in pain 50% less of the time

[00:09:33] less pain meds that that's an effect on your liver and your kidneys you're you're saving

[00:09:39] a big part of your life even though you're not 100%

[00:09:42] where you want to be and with my dad that even though he's not with us anymore I got to

[00:09:48] meet all these amazing patients who got more life

[00:09:53] many of them are still in remission and did get the results that you know they were

[00:09:58] working hard for and the doctors were working really hard for

[00:10:02] and I at some point decided to move here and the guys hired me and it's all history from there

[00:10:10] it's been blessing I'm very grateful every day to see the healing journey of thousands of people

[00:10:17] and they're really humble so they don't talk about it so I will

[00:10:22] so that's how I got here it's through my dad yeah

[00:10:25] he sucked her in yeah

[00:10:27] yeah and and just seeing the facility and seeing you guys as team and culture I understand that

[00:10:31] I'm just being introduced to the doctors they're already they're already throwing firing questions

[00:10:36] and trying to figure out things so they're very passionate clearly you guys are passionate

[00:10:39] about what you do and for those at you out there in the podcast listening to this you know

[00:10:45] I've met both of these great human beings through probably one central source

[00:10:49] probably Dominic Cruz kind of centralized a lot of us and I'm very grateful to be able to help him

[00:10:55] and and everyone the extended family and be part of this we started seeing patients I think

[00:11:01] through probably you were one of our first cases we've seen PRP we've seen a lot of regenerative

[00:11:05] medicine but as we've seen more and more patients over the last few years because our high focus on

[00:11:12] patient experience and outcomes and we individualize things for people every single person that

[00:11:16] comes in as much like you guys everybody has a story and the reason why we care is

[00:11:20] because we're passionate about the outcomes we understand that your dad is there we understand

[00:11:23] that your back is debilitating you don't have that function that's a very big part of your life

[00:11:28] that's like your independence and nobody can strip that from you and for us that's a big factor on

[00:11:33] how we treat patients we know that you just want to get back to doing something that you want

[00:11:37] to do for walk live a better quality of life have another birthday whatever it is and so we get

[00:11:42] that and so we're passionate about it and so as we saw patients post stem cell procedure

[00:11:47] it just made sense we just needed to figure out what the healing times timelines were this

[00:11:51] is a newer procedure what changes with regenerative medicine how does it affect healing rates and then

[00:11:56] we just customize the treatment sessions now the big reason why I wanted to have this podcast is

[00:12:01] because you guys are getting patients from all over the US maybe even world all over the world

[00:12:07] all over the world and he obviously said he's humble about it so I'm glad yeah that's fantastic

[00:12:12] and there's a lot of physical therapists who have that passion to help people just as we do

[00:12:18] however they're not familiar with seeing patients post stem cell procedure and they are different

[00:12:24] it's not a prp injection this is very very different the the the science behind it the healing timelines

[00:12:30] the progressions changes so really my goal today is help the planet understand if they see a patient

[00:12:37] post stem cell what should they expect what an ideal world would you want what do you want

[00:12:42] them to know what precautions are contraindications how do we set up these people who

[00:12:47] investing a lot of time money and energy and passion and they're really you know they have hope

[00:12:53] and you don't want to crush that by doing something that was preventable like being too aggressive or

[00:12:58] being too conservative so Scotty I have a couple questions for you Lola too so Scotty can you

[00:13:04] tell me the science behind this so as a therapist you know at a basic level what's

[00:13:10] happening post stem cells to help them understand now what's happening at the tissue level

[00:13:15] the answer to that question is no I'm not a scientist I won't even try to go there and butcher it

[00:13:22] yeah but I can tell you you know it the thing is is that you know especially Americans like

[00:13:30] everybody wants everything to happen immediately you know I got the stem cells how come it

[00:13:35] hasn't grown back it's been 30 minutes but you know one of the things that I've learned is

[00:13:40] you know the stem cells first they take time to kind of get accustomed to being you know in the body

[00:13:46] and then tissue takes time to grow especially cartilage disc material we do get people we call

[00:13:53] super responders and their body really takes to them very well they tend to be high level

[00:13:59] athletes that break their body down a lot and their body is used to be going through that

[00:14:03] phase you know as opposed to somebody who is not you know going to you know going to the gym every

[00:14:10] day yeah is different than like what Dominic Cruz does yes right yeah let's be honest here are some

[00:14:16] of the other pro athletes that we that we get here so it takes time for that tissue to grow

[00:14:22] then it takes time for that tissue to mature then it takes time for that tissue to strengthen

[00:14:28] and one of the biggest problems that we have is pain tends to go away pretty quickly but that

[00:14:34] tissue hasn't had time to really mature and strengthen so it's very fragile we see it a lot

[00:14:42] people start feeling great quickly and they want to go right back into what they were doing jujitsu

[00:14:47] weightlifting these golf guys my god if you play golf relax it's not the end of the world

[00:14:53] you know you want to go beef swing you just got your back injected and in three weeks you think you

[00:14:58] can go crack the ball for a drive as hard as you can yeah you wouldn't be doing that if you had

[00:15:03] back surgery so I don't honestly I don't you know like I'm not a big science guy I can't tell

[00:15:09] you the exact science behind what what they are and how they work I'm sure there's a

[00:15:14] YouTube video out there that could do a way better job so I don't want to butcher it

[00:15:18] um so I'm gonna default a little bit on that question yeah and I appreciate this guy I think that

[00:15:25] the thing you're seeing is the volume of people you're seeing the success stories you're seeing

[00:15:30] the challenges you're seeing people who don't do well or the the the the super um you know people

[00:15:36] that you mentioned earlier now you said something interesting that I really appreciate um that

[00:15:41] really challenges physical therapists um we our goal we understand tissue healing but here's

[00:15:46] the challenge that we have we know that when somebody has surgery an ACL or knee replacement

[00:15:52] there is a scar and we know there is healing in there right then we know that that person

[00:15:58] is responding with I'm in pain I'm very hesitant to put weight on that so I'm gonna just be

[00:16:02] reserved about it and we as a physical therapist we know that we can rehabilitate somebody it's

[00:16:06] going to take 12 weeks to rehabilitate that no matter what it's going to be 12 weeks why

[00:16:10] because that's normal tissue healing repair six weeks of inflammation or two three days of

[00:16:14] inflammation six weeks of of proliferative remodeling and then going to a true remodeling phase

[00:16:20] that's the basic science behind everything that happens when you have surgery the difference between

[00:16:25] post stem cell procedures and post surgery is that there's no incision there's no localized

[00:16:31] blown up tissue typically that is telling the person I'm in pain and I need this to heal

[00:16:38] it's actually the opposite no incision and this person feels great within three days

[00:16:42] that's a danger zone to physical therapists because we're like wait a minute your symptoms are great

[00:16:48] I can't see what's happening in the in the actual joint so let's push you yeah they think they're

[00:16:53] incredible Hulk and that's a lot of what we're seeing in the physical therapy world I have people

[00:16:58] who call me who say hey Chris I don't know what to do with these stem cells because they're

[00:17:03] reporting 100% you know one weekend and I'm saying no you treat it like a surgery you

[00:17:09] treat it like 12 weeks of healing no matter what even if they feel amazing your job is to make sure

[00:17:15] this tissue healing happens in the best possible um like way and I think that's the hard part they

[00:17:21] can't see the repair they can't see the localized tissue they don't see the incision site and that's

[00:17:26] deceiving because they're like subjectively symptomatically they're like I feel great

[00:17:31] and for us as physical therapists what do we do with an out person who wants to be active

[00:17:34] wants to go to golf what do we say push it let's go let's party and that's the danger zone so

[00:17:41] all in all there's several factors that we said that you mentioned that I want to touch on but the

[00:17:45] first one is they feel great but they're not there yet inside that joint and that as a physical

[00:17:51] therapist you have to keep in keep in mind and I'll I'll review tissue healing timelines but

[00:17:57] for you the people who do best these um high active individuals why do you think that

[00:18:04] they do better than other community members who are going to the gym one to two times a week

[00:18:10] you know again I don't know my guess is you get somebody who's you know breaking their body

[00:18:18] down every day in training yeah when I used to train it was trained till exhaustion and then push it

[00:18:24] and the recovery time you start learning your body and you want to speed your recovery up

[00:18:30] you're doing everything you can do to speed your recovery up so I think anyone who's done that for

[00:18:37] years is listening to their body post stem cells and they are they're implementing whatever worked

[00:18:46] in the past for them for that rest recovery period I understand so strictly hypothesis

[00:18:53] you know and it's not always those people that are super responders yeah super responder is just

[00:19:00] somebody who's the uptake of the stem cells their body seems to process them and put them to work

[00:19:06] quicker it tends in my experience I have no scientific data behind this whatsoever I just

[00:19:12] try to meet every patient and listen to them of course so all anecdotal yeah my experience it

[00:19:17] tends to be those types of people but it's not always those people yeah people that you know I would

[00:19:24] say people that are saying they feel amazing in a week you know that's a super responder or could even

[00:19:31] be placebo you know let's face it how much too she's growing in five seven days yeah much now

[00:19:37] infomations can come way down yeah especially people that do a lot of IV stem cells I always

[00:19:43] tell my patients if you can afford it max your IV stem cell dosage out because the

[00:19:50] positive side effects that we see from that unintentional effects that people are getting

[00:19:57] sometimes they're like miracles it's crazy you and you so do you do you feel that you guys

[00:20:05] get better outcomes if you do IV stem cells versus locals oh sorry in addition to sorry not or

[00:20:11] so if you do a local plus an IV stem so in my opinion and Lola talks to a lot more after care

[00:20:16] patients than I do um I don't think that you need to do a lot of IVs I did zero IV stem cells

[00:20:25] after I got my first bad injection at that time we weren't producing the volume of stem cells

[00:20:31] yeah that we that we do now now we're doing seven eight nine ten billion a week um so I didn't

[00:20:38] do any I don't think that uh IV stem cells are going to change the effects of 20 million stem

[00:20:45] cells in your needs again I don't have any scientific data this is just in talking to people yeah

[00:20:51] what I have noticed when I've done IV stem cells is that all of my joints feel better less

[00:20:58] cracking less pop it I'll get a mass few days of inflammation happened really to me and my wrist

[00:21:06] you know one time I did break this wrist when I was a kid but I hadn't really had problems with

[00:21:11] this wrist but since then after IV stem cells I'm guessing around a month in it just blew up swelling

[00:21:19] and hurt like crazy I hadn't done anything but type on a keyboard with it and went away started

[00:21:24] feeling a lot better I noticed that it loosened up my understanding is that the IV stem cells

[00:21:29] will go out through your body and where they find yeah inflammation they can potentially

[00:21:33] start to heal so there is like a real sense of wellness that grows especially after the first

[00:21:40] month from doing the IV stem cells asthma patients that don't need inhalers anymore

[00:21:46] diabetics that lower their insulin dose we've gotten lots of great results with people with

[00:21:51] heart function liver function different things like that well and and we kind of know why but

[00:21:59] that's not what they came here to get treated and I'll always throw this out there the brain is

[00:22:05] the most powerful drug in all if you think you're going to start feeling better you're likely to

[00:22:10] start feeling better so I won't I won't come away from it saying that maybe it's placebo yeah

[00:22:16] you know the things that we've seen when people change their mind and the whole it teaches

[00:22:21] the power of mind class along with Sarah at the hospital right the effect from one day to

[00:22:27] another on the healing process of cancer patients when they can get their mind right it's it is one

[00:22:34] of the most powerful things so I don't know yeah and so and I'll direct this to you Lola because

[00:22:44] if somebody has a work as a physical therapist we're used to body regions right we treat the

[00:22:49] back and then we treat the knee and then we treat shoulders and all these other things

[00:22:52] and we're very segmented our profession is very segmented with it's just purely based on insurance

[00:22:58] insurance says well you can't treat the shoulder and the knee at the same time unless it's approved

[00:23:02] so for us we have to look at this now when somebody has IV and a localized shoulder

[00:23:07] we're now having a systemic response but we've only gotten approval to treat the shoulder so it

[00:23:12] does change our rehabilitation process and I think Lola you have mentioned this to me before

[00:23:17] where if you have people who have had an IV uh a stem cells via IV it does change their immune

[00:23:24] response or their response with flare-ups or inflammation not just at the localized site

[00:23:29] but other things and as a physical therapist we're not used to that we're like hey we're

[00:23:32] treating your shoulder why these other knee these other joints being flared up can you

[00:23:36] speak to that like what do you typically see in terms of what happens when you add the IV

[00:23:41] and the responses to it yeah I'm also not a scientist or a doctor but I have spoken to

[00:23:48] I would say 90 percent of our patients that have completed treatment I follow their aftercare

[00:23:55] process and my understanding is from our doctors and scientists that we work with is as soon as

[00:24:03] the stem cells go into the bloodstream via IV they work with your body's ecosystem so they become

[00:24:11] a lot of people think stem cells just turn magically instantly in five seven days into

[00:24:17] the tissue that you need but it just simply doesn't work like that stem cells are responsible for a

[00:24:23] lot of signaling right so maybe there's things in your body that you already have to build tissue

[00:24:29] but the signaling is off or the blood flow is not optimal so when they get to that place and

[00:24:35] the signaling is right you get more more healing now we can't every person's different every person

[00:24:42] has different injuries and I hear it all the time like Scott said you know of an injury that hasn't

[00:24:49] bothered a person for 20 30 years they just remember they had a car accident or something hit their

[00:24:55] elbow got IV stem cells three weeks in their elbow is swollen and in a few weeks after that

[00:25:01] they feel amazing because they had a response there does that happen for everybody no but it can

[00:25:09] so we see a lot of it's kind of like a domino effect one thing gets better whether it's from

[00:25:16] a direct injection or IV cells and then they stop overcompensating for an injured you know

[00:25:25] joint so their posture changes or they start doing physical therapy and but then they might have

[00:25:31] pressure on another joint because they're altering their gait and it's so complex right and I think

[00:25:41] the key is I hear your questions and where you're going with it and I think the main

[00:25:48] challenge I would say is what you mentioned is that there's no incision right you can't

[00:25:57] a lot of our patients argue with me on the phone and like try to get my permission to do stuff

[00:26:03] like but but what if I what if I just go light on the bike right after both knees ankles

[00:26:10] injected two weeks ago and right and not your mom I'm not going to tell you no you can't

[00:26:16] do that but we recommend you go to physical therapy and make sure that all your muscles are

[00:26:24] firing properly because you might have the the inflammation and everything go down and you

[00:26:32] feel great now there might be space in the joint where there wasn't before all these things

[00:26:38] but you're still walking and moving as if you were injured right and you see a lot of that

[00:26:45] you did that for me with running yeah so I see that all the time yeah and now I understand

[00:26:51] what kind of patient I was so and I think so both of you have a role that you you see people

[00:26:59] pre or post you see them through um and you help them kind of maximize their experience and

[00:27:04] maximize their outcomes so from start to finish I imagine you're in contact with them throughout

[00:27:08] that time period yeah and the doctors are obviously they know the science behind it they know

[00:27:12] all these other things the challenge to the physical therapist is that say for instance they come here

[00:27:18] in a typical bout of treatment might be one to five days or seven days what what is a normal

[00:27:24] five six days five six days right so they'll come here they'll fly in from out of state

[00:27:29] they stay here for the week and then they fly back home that's pretty common for people that

[00:27:33] that you guys treat here now they're gonna go and look for a physical therapist to help

[00:27:38] them recover with rehabilitation now here comes the next challenge a lot of these individuals

[00:27:43] aren't coming with the prescription from a doctor saying you have to hear none of them are right so

[00:27:50] this is where physical therapy that's the first barrier already for a physical therapist if you

[00:27:53] work in an insurance hospital style system or outpatient where you're not used to seeing these

[00:27:58] people just straight off the the street without a script the first question you ask is uh well

[00:28:04] where's the script what am I treating and then what do I do with this as a physical therapist

[00:28:09] you should know what normal healing rates are and it was done to a body region so you know your

[00:28:13] timeline inherently and i'll explain those timelines so you guys understand a little

[00:28:16] bit more but these people are stuck not knowing what to do next these physical therapists and

[00:28:22] now the patient's like well i was informed that i could now start to work with um work with

[00:28:28] this patient but i don't know what to do because it's been so many weeks or so many months

[00:28:32] my goal is to outline what normal tissue healing guidelines are have an understanding to everyone

[00:28:39] else out there that in an ideal scenario what would you do with these healing rates and what would

[00:28:43] you do with rehabilitation it's not that hard so let me outline just a little bit and you guys

[00:28:49] can see where your patients struggle which which weeks or which months and it's great to hear

[00:28:54] your your input because you see maybe the before maybe the after or the results afterwards

[00:28:59] so let me let me outline this this healing rates all right in the first 72 hours of any trauma

[00:29:06] an injection whatever it is it's the inflammatory state this is where your knee balloons up

[00:29:10] your purple it's blue it's green it's all the above after that after the inflammatory state

[00:29:15] right around day six or day seven it starts another phase called proliferative phase proliferative

[00:29:20] phase basically means all these good healing uh cells are starting to work over time you have

[00:29:26] repair cells coming in and proliferative phase from day six to about day 35 okay so you're getting

[00:29:32] into the five week mark okay so from there at this point that's why they say for the first phase is

[00:29:37] four to six weeks that's very common for anything post-surgical after that you have a remodeling

[00:29:42] phase which is day 35 forever so most people post-surgery or post-injury flare up in the

[00:29:50] first six weeks why because they're now having all these cells coming into them as a physical

[00:29:56] therapist we know that because after surgery in two weeks after surgery we're gonna they're gonna

[00:30:01] come and remove sutures from you right all the stitches are gone that's a normal process at

[00:30:05] the two week mark after that at six weeks is when we can start to push you a little bit more

[00:30:09] now we can start to add a little bit more strengthening then after six weeks it's

[00:30:13] another six week mark so basically at two weeks we know that's a normal healing rate

[00:30:17] at six weeks that's stage one six weeks to 12 weeks is stage two and then at stage two

[00:30:24] is 12 weeks that's when people can start to run jump start to go back to sport so normal healing

[00:30:29] rates post-surgery 12 weeks is the minimum before you can add that stress going back to sport jiu-jitsu

[00:30:35] those type of things so if I had you post stem cells I would have been stretching you getting

[00:30:41] you a stable good balance for the first six weeks but I wouldn't have had any load on you

[00:30:46] until week six why because I have to have those cells repairing then I get six weeks to get

[00:30:52] stronger and then at week 12 then I get to introduce you into any form of training that you would do

[00:30:57] now that's a conservative approach everywhere inside there if I have a dominant cruise or somebody

[00:31:02] pro fighter I'm probably gonna play with the timelines a little bit more but I have to respect

[00:31:07] healing I have to no matter how good you feel and you say Chris I want to roll tomorrow come on

[00:31:13] just a little bit like you know I won't I won't do anything on the mat it'll be standing the

[00:31:17] whole time I know what happens I know what happens I give you a little bit you take

[00:31:21] I give you an inch of take a foot for me if I know that 12 weeks is normal every physical

[00:31:27] therapist should take that same approach the only thing I've heard talking to the doctors here

[00:31:33] is that the IV stem cells just change that a little bit more in low life talk to you about

[00:31:38] this and I think physical therapists out there if you're like hey Chris how do I work with

[00:31:43] these post stem cell patients it's no different than your 12 week timeline it's no different

[00:31:48] than a normal 12 week timeline and after talking to the doctors that's exactly what they said

[00:31:52] they're like an ideal world you're just understanding it's going to be 12 weeks

[00:31:56] to get these people better now there's always cases of super healers and people who don't have

[00:32:01] the best outcomes we get that but inside 12 weeks you're doing nothing different

[00:32:07] than if it was a post surgical case and you're progressing them through that

[00:32:10] now the thing that happens there is the IV Lola in your experience and what people have

[00:32:15] done after talking to the docs they said those first two weeks are they do change because

[00:32:20] people have immune responses what has been your experience with people who get the IV stem cells

[00:32:27] I would say that after the first couple of weeks people can get back to their normal life

[00:32:32] generally but we just never know those old injuries that they don't even remember about

[00:32:38] his wrist yeah exactly like we could there's no way for us to predict that your wrist was

[00:32:43] gonna have that response but generally those flare-ups don't last more than a few days to a week

[00:32:54] and we just advise people that when they have a flare-up reach out we have an aftercare

[00:33:01] doctor medical team that gets in touch with people and kind of guides them through that

[00:33:07] and so that's important to know so but what you don't want and I imagine this can happen

[00:33:14] is if the physical therapist or anybody helping with rehabilitation if they don't know what to do

[00:33:18] they're just gonna keep directing the patient to you and you're like I'm we can only do so much

[00:33:23] remotely you know there's clinicians who know what they can do the promise is a new procedure

[00:33:28] they're scared to mess it up obviously they don't want to do anything wrong

[00:33:33] our goal is to educate them so that they have the normal standards and they can actually work

[00:33:40] with these patients on their own without having to call you for every question that to me would give

[00:33:45] you give them so much more power and give the patient so much more independence without having

[00:33:50] to rely on you guys calling you every single day I imagine there's some people I can't imagine a world

[00:33:55] so all right so

[00:33:59] you're surprised the calls we get sometimes I stub my toe is it gonna ruin my stem cells

[00:34:03] I see okay so to lighten your load and help clinicians because the biggest thing that they

[00:34:11] don't know is what's happening why is this different than any other procedure I've ever done

[00:34:16] and if they have a flare up at their wrist but I'm treating their knee what do I do

[00:34:20] is this a is this a negative side effect that's the biggest concern honestly that's all they're

[00:34:25] caring about but if they understand that with IV stem cells that they could have responses all over

[00:34:31] the body that have maybe nothing to do with the localized site that's a big one for them to know

[00:34:37] that there is some normalcy inside that after talking to the docs I heard two weeks is a good

[00:34:43] timeframe where they might have immune responses to these IV stem cells so if that were the case

[00:34:49] all I would do is push the 12 weeks of recovery shift it plus two weeks basically so it wouldn't

[00:34:55] be 12 weeks it'd be 14 weeks if they get IV stem cells that's the only thing I would change inside

[00:35:00] this so now you have a 14 week recovery with IV stem cells but if you don't and you just have

[00:35:05] localized it's going to be the normal 12 that is probably one of the biggest takeaways that

[00:35:10] I took after talking to the doc so it was so helpful to understand patients will have

[00:35:16] immune responses that's very normal and it might not be at every or it might not be at the localized

[00:35:22] site that's important to know from you your guys is response you're a patient advocate you see them

[00:35:28] throughout this whole process you might see them pre-post what are the things that they struggle

[00:35:32] with that you wish that physical therapists or healthcare providers would know about this

[00:35:37] procedure to help the patient outcomes what are some things back up one before that the first

[00:35:43] real question is how do I pick a physical therapist oh oh yeah just go on google and type in physical

[00:35:52] therapy oh that's a phenomenal question I was not ready for this guy and I appreciate that

[00:35:59] all right so 100 you're going to go on google and you're going to say uh physical therapist

[00:36:05] and then you're going to look at google reviews and the problem is it's associated with a clinic

[00:36:10] right so clinic will say 305 star reviews and you can go through all those things and you're

[00:36:15] going to look for the person who's been mentioned the most that's probably what people are going to

[00:36:19] do naturally right there are some credentials that help you as a consumer understand qualifications

[00:36:27] so we all know that if you have more certifications it that person is hungry for

[00:36:31] education they want more it doesn't always mean that their care is going to be better

[00:36:36] so it's hard to it's hard to present that okay so the first thing I would do is look for people

[00:36:41] who have certain credentials is one of them there's a good starting point you can do the google reviews

[00:36:46] perfect you've locked you've locked it into the top five clinics that you like in

[00:36:50] indianapolis indiana perfect then you're looking for some credentials there are some

[00:36:54] credentials that are highly respected in our profession uh an OCS orthopedic clinical

[00:36:59] specialist is a very tough exam to do not everybody has it a sports clinical specialist

[00:37:04] an SCS these tell you that they are progressive then you might have some strength and conditioning

[00:37:09] certifications like a CSCS this person likes working with athletes or active people from there

[00:37:16] then you can read on their bios you know what is this person what type of training has this

[00:37:20] person had have they done a residency that's a big one not everybody has a residency in medicine

[00:37:25] in the us all physicians have to go through residency some do fellowships in the u.s now

[00:37:30] only a certain proportion of physical therapists go through residencies i at the time i did mine in

[00:37:35] 2008 and 2009 i was one of five people in the us who did residency i explained why you're so good

[00:37:43] i appreciate that scottie um but you what you really understand this is a hard part of of

[00:37:48] healthcare i care about what i do right like i'm obsessively passionate about humans right

[00:37:54] i asked you earlier before the podcast i was like hey um where are you from and you you said

[00:37:59] that's a hard question it's a hard question and ultimately what you really understood was

[00:38:04] you just got to know who people are why they make the decisions and who they are you can figure that

[00:38:08] out upon meeting somebody you like you can read that person to me that's my passion so when i have

[00:38:13] patients in front of me i just i'm a gypsy too so i get that so i just need to know what is that

[00:38:18] you're looking for i'm going to help you attack that i don't care that you stub your toe i

[00:38:21] respect that but what do you want to do you want to roll perfect how far how how far out

[00:38:25] can i get you to to be patient with me 12 weeks can you wait for me for 12 weeks all right you

[00:38:30] will need to be with me let's let's barter let's bargain i understand your goals as a human i get

[00:38:34] that you want to run lola i understand that and most physical therapists they just want to change

[00:38:39] the knee range of motion they want to get more flexible and the concept of getting the human

[00:38:43] to where they want in a time that they want is foreign to people that's the only reason

[00:38:47] why i love what i do and every member of my team has that same vision now every healthcare

[00:38:52] provider doesn't have that that's the challenge so i can't tell you that you're you're gonna have

[00:38:56] to stumble upon that but what you're gonna do is you're gonna go on google i appreciate that go for

[00:39:01] the reviews you're gonna free people who with higher level credentials doesn't mean if they don't

[00:39:05] they're not good i'm just telling you how do you kind of filter a little bit more um and then

[00:39:10] you look for their bios and and see if they've done a residency of fellowship um and that

[00:39:13] they've gone beyond the baseline level of education that's probably what you would do

[00:39:17] for a dentist you're looking for like somebody who is highly qualified has done this before and

[00:39:22] works with active people that's probably what you're searching for because the people that you see

[00:39:26] want to be more active or else they wouldn't have this right they're currently debilitated sure

[00:39:32] and they want to be more active than they currently are so for me um those would be my

[00:39:36] three standards um to help you choose a physical therapist um what has worked for you guys in

[00:39:40] the past what's been the what's been the algorithm that you guys do i hate yelp so i tell

[00:39:45] people go on yelp um and look for people that have a lot of good reviews the thing the first

[00:39:50] thing i always do is ask for personal referrals like just ask me a lot of the people that we get

[00:39:55] not everybody but a lot of people that we get down here are athletes in some way or another

[00:40:01] but i would say most of them that are getting treated obviously for muscular skeletal stuff

[00:40:06] are active people yeah and so the first place i say is you know go ask around at your gym

[00:40:11] ask around on the golf course ask around find somebody who's happy with the person that

[00:40:16] they went to the other thing i've heard from a lot of patients is that um well two different things

[00:40:23] you know one if you call your your pc and you say oh doc the pain my shoulder right you can

[00:40:28] probably get your insurance company to pay for your physical therapy however i've heard from other

[00:40:35] patients that if they go through their primary care kind of like what you said like well they

[00:40:41] i got three places injected they want me to come back three times a week you know that's how the

[00:40:46] insurance system people complain about big pharma but you can play about big insurance they control

[00:40:51] more of our health care right then pharma ever does um and so they find it's more valuable

[00:40:57] to just go in and say i don't have insurance and cash pay boom it's usually cheaper and they

[00:41:02] can get everything they want done in one session that is a um a big thing for patients to do and

[00:41:11] physical therapists believe or not we're just not used to that we're not used to a cash pay

[00:41:14] person come in saying hey i would like to direct my care and have you help me alongside that the

[00:41:19] physical therapist usually uh whatever the primary or the ortho says this is what we're supposed

[00:41:24] to do here the five things you can touch and here's the six sessions you're allowed

[00:41:27] so it's very boxy in this scenario patients it could be their back their neck they had six

[00:41:33] injections their neck four at their low back and two at their big toe and now you have to be

[00:41:38] able to get that and they want to be able to roll in six weeks or 12 weeks what do you do with that

[00:41:42] well it's just an equation but it's 12 weeks let's figure this out we'll do it all but physical

[00:41:47] therapists were used to segment it i can only touch the neck for six weeks can only touch the

[00:41:52] back for four weeks i only got eight sessions for the toe sometimes it is better for these

[00:41:57] patients to pay cash pay why they're already investing a lot of time and money to come down here

[00:42:01] and i don't know what your guys ratio is what ratio would you say how important it's a procedure

[00:42:06] and how important is the rehab afterwards what percentages would you say

[00:42:10] like 50 50 like 63 to 64 talk to this too but when patients come in to me especially with

[00:42:16] like shoulders or instability and they're unhappy with their results i'll say i'll because i don't

[00:42:21] want to say like hey did you do physical therapy i'll say what did your physical

[00:42:25] therapist have you do fair you've already assumed and then look at that and they'll go

[00:42:31] i love that i love that one physical therapist i'll say

[00:42:35] then if it's a shoulder i'll say so are you a side sleeper yeah they'll go uh yep and i go

[00:42:40] well you're never gonna get out of pain until you've got a physical therapist so that's fair

[00:42:44] even if the stem cells completely reattach your rotator cuff if you're you know not doing

[00:42:49] something to realign your shoulder you're never gonna get out of pain yeah and then another

[00:42:55] patient favorite is i'll ask i'll be the did you do physical therapy and uh and they'll be like oh yeah

[00:43:05] you know i do physical therapy in my garage all the time and that i already know why they're in

[00:43:11] pain what they did and i can you know i fill in the blanks and then i just follow up with

[00:43:17] the doctors after and when they re-injure or re flare up or hurt themselves it's because they were

[00:43:26] trying to do some something that they did post their injury before that they think they remember

[00:43:32] the proper way the physical therapist showed them which i have to have you remind me after

[00:43:39] 25 visits what we did last time of course you're like you're doing it wrong you're human yeah and i

[00:43:46] patients try to try to do that and um a lot of times like we do put a huge emphasis

[00:43:54] on physical therapy just for them to find one and do it and commit to it um but people

[00:44:01] create their own interpretations of what that means and a lot of times get themselves in trouble

[00:44:07] yeah um but the people who do follow through aftercare instructions and have a great physical

[00:44:15] therapy partner we just we tend to see that those people do better long term and don't re-injure

[00:44:20] themselves and give themselves time to to heal properly and strengthen all the tissue around

[00:44:26] the area that got injected is that i know that the doctors also um are always concerned about

[00:44:34] preserving muscle tone yes and that's like a big thing after surgeries but after surgery

[00:44:41] you're laid up you're doing nothing because you can't put weight on like if you get a knee

[00:44:46] surgery you're in a boot and on crutches and uh it's it's a different uh different process right

[00:44:54] right and that's interesting what i'm comment on is that we hear from patients that they're

[00:44:59] physical therapists say oh you're gonna lose muscle mass if you don't hurry up and start

[00:45:03] doing something i can tell you we've had crossfitters power lifter guys that come down here to do IV stem

[00:45:09] cells um and when you have all those stem cells in you that mass is going to come back a lot quicker

[00:45:15] than before you have 150 extra million stem cells running through you yeah and and i think the fear

[00:45:22] of the muscle mass is because we're not used to these cells that help angiogenesis the cells

[00:45:31] that help you promote um cellular growth and activity we're not used to that we're used to

[00:45:36] something's been carved out of your bone and now you have inflammation but you don't have these cells

[00:45:41] are actually helping growth factors so for us that's the barrier it's almost like we wish that

[00:45:47] they were in the boot because now now they actually are like yeah it's so crazy because you guys

[00:45:52] are doing a procedure that's non-invasive non-operative that mimics recovery operative

[00:45:58] which is that that's that is the biggest thing that physical therapists need to understand

[00:46:03] your question i really appreciate your question how do you find the best physical therapist

[00:46:07] anytime little ask me hey who do you know in silicon valley who do you know in austin texas

[00:46:13] that's the first thing that i'm going to do now i'm a physical therapist so i can read through

[00:46:16] a lot of the jargon i can read through a lot of those things and i can see the bio and then

[00:46:20] i'll do a couple phone calls and texts and be like hey i have a network here's my my 50 studs

[00:46:25] all over the the u.s so i can help with that i get that but obviously that number one has that time

[00:46:31] so we're trying to create a resource for physical therapists who are interested and knowledgeable

[00:46:36] in treating these individuals that we can create almost like a google map and you have like a really

[00:46:41] easy place to identify well somebody's in minneapolis and somebody's in florida um these

[00:46:46] are your kind of your go-tos so that's currently what i'm working on at the moment to help

[00:46:50] you guys with this obviously for me i'm passionate about physical therapists who want to be above

[00:46:56] the baseline level of care and it's really unfortunate in this planet there's people who

[00:47:01] did their do the bare minimum um and the people who listen to this podcast you're clearly

[00:47:05] wanting to do something more um and so if you want to be on that list and you want to be able

[00:47:09] to see you know patients with post stem cells and you want to help people um get back to rolling

[00:47:14] get back to running um and you're not scared of treating these people you're you're not timid

[00:47:19] when it comes to doing these things um you know send me an email uh send me a direct message i love

[00:47:23] to be part of this um going back to the question what is the biggest challenge you guys see with

[00:47:30] people going back to physical therapy give me you found a good physical therapist what are the

[00:47:35] challenges that you guys are seeing for the first 12 weeks um it's twofold uh one side is

[00:47:44] you know somebody's been in pain for 10 15 20 years and suddenly they're not yes so there's this

[00:47:49] really really like impatient period of time where they understand they appreciate the result

[00:47:57] they're like i feel so good and they're doing physical therapy and they're not having flare-ups

[00:48:02] and they're not in pain and they really try to rush that 12 14 week timeline because they're

[00:48:09] they're trying to make up for a lost time you know especially the people who get rid of nerve

[00:48:13] pain yeah those are the ones that are like you know they've been on pain meds for a decade yeah

[00:48:21] you know we have people who weren't able to feel uh they're because of really bad pinch

[00:48:27] nerves or sciatica and stuff weren't able to feel or move their toes and how they can so they

[00:48:32] want to do all the things and um slowing people down because not only is the patient impatient yeah

[00:48:41] but a physical therapist can you know get a little ego involved like look i'm i'm doing so well

[00:48:48] pushing you you're improving so there's that twofold so that's one challenge is that the

[00:48:54] super responders or people who are just out of pain and want to get back to life and this is

[00:48:59] why they did this yes and then there are people who are slower in the recovery timeline um

[00:49:07] and have a lot of inflammation and when we work especially with like shoulders like really

[00:49:12] banged up shoulders with people after multiple surgeries and that takes time yeah and they're

[00:49:19] impatient with the physical therapy because they'll do a little bit and then they have

[00:49:24] a flare up yeah because there's so much stuff happening there and the injuries just some people

[00:49:31] take a longer time to heal you know somebody might at four weeks be pain-free somebody

[00:49:37] might take the full 14 weeks to get to that point where they have yeah you know inflammation

[00:49:42] come down and their range of motion is back so just understanding where you're at in the healing

[00:49:50] timeline where you were in your injury timeline yeah and respecting that and just patience on both

[00:49:58] sides of the spectrum you know softer tissue takes it usually grows faster and harder tissue

[00:50:08] cartilage bone will take a long time and just people respecting that timeline is

[00:50:15] really difficult to communicate so when they do go to physical therapy and the physical therapist is not

[00:50:23] respecting the timeline or appreciating how the healing process works it feels

[00:50:30] very conflicting sometimes I feel like it's not supportive to the patient if a physical

[00:50:35] therapist was like well you should be able to be to do this by six weeks yeah I try

[00:50:42] no and I appreciate that the thing I'm taking from this is as a physical therapist let's assume

[00:50:49] let's assume they're gonna heal in 12 to 14 weeks that's going to be the healing rate

[00:50:54] so if they feel good in between there it's okay no need to try and put them into like a

[00:51:00] super healer phase just respect the timeline get them to the 14 and play it safe because

[00:51:05] this is a procedure you don't want to do multiple times if you could have done it right from

[00:51:08] the beginning exactly yeah you can have touch ups two and ups whatever it is that they come in

[00:51:12] you know a couple times or I don't know if you have people who come in for multiple injections over

[00:51:16] one two three years you know we do we do most of our patients could and are one and done

[00:51:22] the thing is is our goal is to get these stem cells FDA approved yes I need data to do that

[00:51:28] I see so when we first started out you know somebody that was doing well or somebody that

[00:51:34] wasn't either way begging them to come back to Tijuana for no real benefit of their own didn't work

[00:51:42] got it you know so we had to develop what we call an ethical bribe say you come back I'll pay for your

[00:51:50] MRIs I see you need the data I'll give you $10,000 in free stem cells yeah so not good for my

[00:51:57] short-term margins but you need data yeah yeah especially when we have an MRI machine shortage

[00:52:03] down here in Tijuana but the data is is fantastic yeah to get all of that data and sure the people

[00:52:11] that are doing well is is great and I love that they're doing well but when patients aren't doing

[00:52:17] well and getting to figure out why that's where the real value is and that's where

[00:52:24] my experience of people I talk to yeah if you you know there are people that do great

[00:52:30] that don't do any physical therapy wow the people who aren't doing as well as they like

[00:52:35] they might have like a lot of improvement everything like that but you know like I said

[00:52:39] shoulder pain is a huge one knee stability like hey I have no pain in my knee but it still feels weak

[00:52:45] you know I can almost guarantee you every time they did no physical therapy I got it so I went

[00:52:49] through for the sub the subjective response there like hey I feel great so they went off of

[00:52:53] that which is crazy too if you have knee surgery that's what I'm saying it's almost better

[00:52:57] if you didn't do physical therapy I say you guys just put a little incision so that way

[00:53:00] it's a little floor you know one thing I was going to mention is I always I always uh

[00:53:06] I always encourage our patients to bring their radiologist report if not the MRI film there

[00:53:11] they know where they get got injected yeah they can point it out now all of my MRIs are in Spanish

[00:53:17] guess what country we're in it's another thing hello Americans guess what not everywhere in

[00:53:21] the world is English is the first language I know some of you never travel out of the

[00:53:24] country you're clueless about things like this but we have this thing called chat gpt where you can

[00:53:30] take a picture of your MRI and it will translate it all for you end of public service tell them Scotty

[00:53:37] I appreciate this how many times a week I have to say that you know that should be part of like

[00:53:42] your post uh your your discharge packet like oh really screenshot chat gpt enter copy paste

[00:53:49] read report completed you know find me a good health facility isn't full of Latinos anyways like

[00:53:56] come on son you know the most caring ethnic people I've ever met you know like there's

[00:54:02] some way to speak Spanish wherever you go in any health industry in this country so that that's

[00:54:06] a thing that that pts run into right so it's obviously in Spanish so like I'm in the middle

[00:54:10] nowhere Alabama what do I do with this yeah so chat gpt great we got that um for you

[00:54:16] um what are when you have these people who are flying from from in and then they're coming out

[00:54:23] what are you using as your data besides subjective like I feel better um obviously FDA will have a

[00:54:28] challenge with just a report of zero to 10 pain and actually they like that oh really and we

[00:54:33] have an automated survey system uh that goes out where they starts out weekly and then it goes

[00:54:40] to monthly okay and then we have a series of uh MRIs uh depending upon you know so I can't do this

[00:54:47] forever you know yeah um so each month we kind of look at how much how many people because you know

[00:54:53] people that live far away that feel great yeah I don't they don't give a rat they're out they're

[00:54:56] done you're giving them yeah coming back yeah I get that so and that's okay you know what I mean

[00:55:00] I want the data right but that's okay um so you know each month we kind of take a look at it

[00:55:05] and see okay how much more data do we need to collect you know so we did only three months for a long

[00:55:11] time yep but then we started after the three months having patients return six eight months a year later

[00:55:17] that just wanted to come back for treatment a lot of times we just want to come back for IV or they

[00:55:21] hurt something else and these are paying patients and they would come and I'd say hey yeah let me get

[00:55:26] an MRI I'll pay for it there we go okay okay and then we're looking at it and we're seeing

[00:55:31] man this guy's you know just like mine yeah if you look at if you go on it's on my Instagram if you

[00:55:36] go on my Instagram you'll see that even though 90 days after my stem cell procedure I have an MRI

[00:55:42] there the week before nine uh 90 days out in one year out yep at the 90 day mark completely out of

[00:55:50] sciatic pain for the first time in a decade like well I can do anything run up and downstairs

[00:55:56] I couldn't walk up and downstairs before and but the improvement in the discs yeah there were some

[00:56:05] looked a little bit better sure a year later they don't even look like the same discs

[00:56:11] Dr. Beaho our interventional radiologist here was like Scott if I didn't know you personally

[00:56:16] there is no way you could convince me that before and after MRIs we're the same person so as

[00:56:23] we started to see that we said hey you know when we saw mine let's get more data and so right now

[00:56:30] we're actually doing two free returns 20 000 plus all free MRIs to get the data to get this to get

[00:56:37] this data I appreciate it and we're seeing more and more that with our type of hypoxic stem cell

[00:56:42] low low oxygen stem cell that these cells are living for a long time and people I wouldn't

[00:56:49] be surprised is after we finished getting all of our year data we started inviting people back at 18

[00:56:55] months or two years because you want that you want to see where the where the peak is because you don't

[00:56:59] right now you know that the one year is kind of a peak but you don't know if that's going to continue

[00:57:02] we've had patients that felt nothing for three four months and then in months six or eight they

[00:57:08] call all of them and they're like oh my god I feel fantastic you need more data I understand

[00:57:13] I see no one's collecting data like this you know there's a lot of really good stem cell

[00:57:17] places yeah out there yeah but you have to really be willing to take a bite in your bottom line I

[00:57:24] understand to collect data like this and to me it's like you honestly have to care is a long game yeah

[00:57:28] yeah of course of course creating the long term the best experience possible for the patients and

[00:57:34] you know data is valuable too but it's not cash in your business sure in five years worth of

[00:57:39] having all that data we can move forward with the FDA and if these become approved with the

[00:57:45] FDA with the patents that we hold that's a lot of money right right but you gotta you gotta stay in

[00:57:51] business all that time before that I understand before you get to that payout and that payout may

[00:57:55] never come yeah I understand so you have a risk there yeah sure um so obviously doing MRIs we talked

[00:58:00] about CT scans there's another option um but MRIs right now you're going to be your standard to

[00:58:04] look at what does that look like pre and post correct that's your ultimate goal and of course

[00:58:08] it has to be on the same MRI machine with the same radiologist to be accepted into a study

[00:58:13] wow people always say why can't I get an MRI back home and send it to you

[00:58:18] I'm like oh the FDA would let you do it it's a lot easier for me but it doesn't work like that

[00:58:23] you know you appreciate our accents and tone change I can't imagine what your office is

[00:58:27] like I love this because I get it I understand um I a couple more questions one um do you see

[00:58:35] something um that can help facilitate or supercharge this person's healing and minimize

[00:58:41] the risk of flare ups um what would that be inside their first six or 12 months what do you hear that

[00:58:48] if done will help minimize or improve their outcomes with a reduction of uh an injury

[00:58:56] or flare up what would that one thing be what do you hear Lola and then I'll tell you the biggest

[00:59:00] one is not having a physical therapist give them weights at four weeks oh really really yeah I would

[00:59:09] have never done great let's start weights four to six weeks I see they're not ready yet because

[00:59:13] they're having hit that marker now if it normally was six now they're pushing out to eight because of

[00:59:17] the two weeks IV so they have a month more to go so they push them early yeah because if there's no

[00:59:22] flare up yeah you know they they could have stayed the path and stayed the course stayed the course

[00:59:29] stayed the course give you an example my mom uh tore her meniscus in June of 2022

[00:59:37] it's almost a year and a half ago um she was so scared of surgery we went to Mount Tynan New York

[00:59:43] they were like 100 you need surgery yeah at that time she was 65 they're like you you need

[00:59:51] surgery you're not going to recover on your own you don't work out you're not an athlete her knee

[00:59:55] ballooned like the three times the size and she had a cyst so after three months of trying to

[01:00:01] convince her to do stem cells she finally caved I brought her down they joined the cyst put the

[01:00:07] stem cells in and then I had her on proper physical therapy protocol in New York amazing

[01:00:17] Dr. Dr. Stern and he kept her on that timeline yeah and just follow the path she had zero flare

[01:00:24] ups yeah she didn't overdo it we have stairs in the house it and let her go up and down

[01:00:29] the stairs all the time like she would with a laundry basket which is weight right people don't

[01:00:34] think about the household daily things that they do which put stress on the area um she had zero

[01:00:42] flare up we got MRI did her 12 month follow-up um this past few months ago and her meniscus is

[01:00:51] 80 healed like complete like there's one little patch left she's 67 now and at that she's not an

[01:00:59] athlete but she is a super responder because she was like really follow the path right the path and

[01:01:06] does that mean that every person who's going to follow the aftercare 2t is going to respond the

[01:01:11] same no but do you have higher chances of having a good response if you're not aggravating

[01:01:19] that area over and over yeah yeah so you would say just follow the path don't push too hard even

[01:01:25] if they feel good that's really especially at that early mark that four to six week mark yeah just

[01:01:30] patience and like our golfers like we could say it over and over again but it's it really comes

[01:01:37] back to the same thing be smart listen to your body and you know it's it's a lot of money

[01:01:43] protect your investment yeah of course that's the biggest thing that's real no sky what would you say

[01:01:49] you know i would say is not people not listening to their to their bodies and um many of the people

[01:01:57] think they're going to get the flare up in the instant of when they're exercising and they're

[01:02:01] doing something yeah i see frequently it comes in the middle of the night interesting and so

[01:02:08] you know i always tell patients when i talk to them i said if you start feeling the least bit

[01:02:12] of uncomfortable or pain say you're walking a mile yeah you know that's what you're doing is to

[01:02:17] stay active and at a half a mile point you're like oh my knee feels a little bit weird walk home

[01:02:24] you know sure if you if you wait till you actually feel some pain or start feeling a little swelling

[01:02:30] you're gonna be hurting i see you're gonna have a bad bad flare up but it

[01:02:35] i think people think that it's it's gonna happen in the instant of that you know i think

[01:02:41] you know your body is doing some healing while you're sleeping and that's why it comes about when

[01:02:46] that's happening also the pain that's caused by flare ups is bad the immune response that's caused by

[01:02:55] it is just kicking in your immune system right so it can't have advanced the healing process

[01:03:01] if it's not overdone right frequently with runners i try to explain them if you're trying

[01:03:07] to grow cartilage back and you want to hurry up and go run again the same thing that pounded the

[01:03:12] cartilage out right that brand new baby cartilage right isn't gonna last right so you might need

[01:03:19] to do something different than trying to run five miles a day right but that's what they're used to

[01:03:25] because that's i get it yeah and in their head they have an expectation i imagine you're just

[01:03:29] managing people's expectation all day that's all we're doing that's literally right and and okay

[01:03:35] so you guys come to our clinic we're gonna do the same thing because you're like hey i want to run a

[01:03:39] marathon in three months and we're like oh i love that you feel that way but there's some things we

[01:03:44] got to do to make sure if you're like hey i want to roll yeah your calves don't agree with your hips

[01:03:49] don't agree with that and you're like hey cuz i want to roll in uh six months and my back is

[01:03:53] thrashed or whatever it is it's now we have to match expectations have been like that's possible

[01:03:58] but that means you have to have zero flare ups for the next six months now that's not my job

[01:04:03] that's your job because now you have to manage stress outside of me and that the problem becomes

[01:04:07] physical therapists we're not used to where our profession is based on progressing stress

[01:04:13] you guys like that is our job if you're weak we get you strong our goal is to take you from

[01:04:18] here and up we're not used to keeping you at bay meaning if you're healing our job has always

[01:04:24] been well let's get you stronger let's get you more mobile let's go more flexible and what

[01:04:28] this procedure you're saying is you're actually not progressing you're keeping them at bay

[01:04:32] with good stability working on things but you cannot add stress or load early because if you do

[01:04:39] you're going to flare them up and our profession is based on adding stress to create change and

[01:04:46] metabolic and physical changes that's why this procedure is foreign to us because you guys

[01:04:52] are saying don't add stress until week four six or eight whatever that marker is because these

[01:04:57] things are healing well the patient is coming in saying expectations are i am i'm going to be running

[01:05:03] soon because i now have new baby cartilage in my knee and i'm ready to run a marathon physical

[01:05:08] therapist says i've never seen this procedure let's add more stress because i want you to look good

[01:05:12] so we just keep adding stress so the patient's expectation the PT expectation is

[01:05:16] let's add stress and yours is and then rip there we go so that's where this is all going haywire

[01:05:23] your expectation and the doctor's expectation of what healing should be

[01:05:27] is don't mess this up for 12 weeks it's a brand new procedure you let it sit you let it bake you let it

[01:05:33] marinate and you just let it cook for 12 weeks physical therapist is like well what am i going

[01:05:38] to do for 12 weeks they're just sitting twilling the thumbs and patients i want to golf i want

[01:05:43] to golf but you're feel great yeah so you're basically buying time for the first six to eight

[01:05:48] then you get to load them at the six to eight week mark and then you get to have fun

[01:05:52] but most patients if even if you tell them that they didn't hear it oh no they don't hear anything

[01:05:59] i say one month they all they heard i say three months they heard one did you say well did you

[01:06:03] say tomorrow is that what you said right there yeah so our job is to provide a roadmap or an

[01:06:08] outline for patients but knowing that what you want we can deliver on that we're just not used

[01:06:13] to it and that's really why i wanted to bring you guys on here and like if you can talk and

[01:06:17] speak to a physical therapist after you've been googled yelp and you know word of mouth they

[01:06:21] searched you out and you're going to be the physical therapist you've earned the honor

[01:06:25] to work with this patient post stem cell and especially if it's your first one

[01:06:29] you're gonna want to be a superhero i know you i every physical therapist at a certain level

[01:06:35] they're type a ocd they're they're very very good academically and in the clinic they're

[01:06:42] great human beings they're type a drivers they're good at what they do so they don't want to be

[01:06:47] wrong so what they're gonna do they're gonna flare them up because they don't they don't intend to

[01:06:51] right this is physical there because you guys see they're like studs they want to be good at what they

[01:06:55] do they're just not used to hold on yellow light we're just going to cruise for the next six to

[01:07:01] eight weeks they're not used to that and so those who are listening to this if you can understand

[01:07:05] it at the grand scheme your job is not to mess them up for the first six to eight weeks add

[01:07:11] the load at six to eight at 12 you then you can have the discussion of going back to the

[01:07:15] gym or rolling or whatever it is but you're not doing anything inside that then what we don't know

[01:07:20] is where is the peak of their of their healing is it six months is eight months is it one year

[01:07:25] or could it be 18 or 24 we don't know that yet so just know this is not a prp injection

[01:07:31] this is not a post surgical procedure this is a stem cell that is healing and growing

[01:07:36] and they need time on their hands with a little bit of stress that's fine tuned

[01:07:40] and if they flare up it's okay bring them back down you don't have to call the patient out of a

[01:07:46] kid every single 30 seconds if they stub your toe just know this is a long journey with immune

[01:07:52] and localized flare ups and that's a normal part of the process that to me is really

[01:07:58] wanted to accomplish to have you guys on this podcast to share your knowledge you guys are

[01:08:01] doing amazing things and there's physical therapists out there that who can benefit from it and

[01:08:06] really just wanted to share that with the world so I appreciate you guys having me on here

[01:08:12] if a physical therapist had questions I'd love for them to reach out whether you're listening

[01:08:18] on YouTube or Spotify or whatever it is there I'll have a link to having a direct call with me

[01:08:23] if you guys need any help or support I'm happy to help any patients that you guys have

[01:08:27] ultimately we have a network of patients who need the help and we're trying to create a

[01:08:33] network of people who want to be able to be part of this to help people like yourself

[01:08:37] who've broken back to knees and all these other things we appreciate the stories and that's what

[01:08:41] we want to do um and if these patients are excuse me if these physical therapists had any

[01:08:46] questions about the procedures where can they find you how do they find you guys

[01:08:51] well dr chris slow your horses I'm seeing 35 40 patients a week I was planning on sharing

[01:08:59] this podcast with every one of them I think you probably have your own patients that you want to

[01:09:06] deal with you don't seem to understand how the phones blow up here at cellular performance

[01:09:12] institute so I would say to stem cell patients listen listen to the doctor here listen to this

[01:09:19] is the best the best physical therapy I've ever had I feel so great all over the place you guys

[01:09:23] are great I'm two plus years out I still get in there every time I'm part of your

[01:09:28] subscription package um I send everybody I say hey you live in SoCal they got two locations go to

[01:09:35] sports three now uh three locations oh where's the third one pretty amazing right yeah even better for

[01:09:39] those c people okay good I thank you I'm gonna have to let people know about all three of them now

[01:09:46] but just listen to what he said even if you feel like you're physical you know I get it you

[01:09:49] want to get better faster quicker yeah but listening to what dr chris just said for that

[01:09:55] first 12 month 12 week period listen to what you're saying and listen to your body even if all

[01:10:01] of a sudden your physical therapist is like let's double the load on the stack take it take a breath

[01:10:07] and say hey let me go slow this is baby tissue um that I'm growing and it takes time it really

[01:10:14] takes time you know it's like a you know a baby isn't made in a in a week right that's a good

[01:10:20] point nine months growth how do you expect that to happen in so your body in a week

[01:10:25] I now do I say all the time I say hey if you want to know whether or not you should do something

[01:10:29] for the first three months ask yourself if you would do it with a three month old baby and

[01:10:33] everyone laughs but I'm pretty serious that's a pretty good way to see you know can I drink a

[01:10:37] bottle of wine a night would you have a three month old baby drink a bottle of wine no can I

[01:10:41] go back to benching 250 pounds would you have a three month old baby bench can I clean out my

[01:10:47] garage would you have a three month old baby clean out my garage can I go on a five mile

[01:10:51] hike would I have a three month old it works pretty damn good you know right but people don't use it

[01:10:55] they think yeah just joking that's actually probably one of the best things I might just

[01:11:00] introduce when when patients are on the table that's a easy way to see it because they can

[01:11:04] internalize they can visualize that oh you think it works yeah I'm not saying it works at all

[01:11:10] I mean that's that's a beautiful way to say that I saw spoke to the docs and they said you

[01:11:14] know honestly if it takes nine months for a baby to develop from like fetus all the way through

[01:11:19] how do you expect this truly to work the miracles that you expect in a week it's just not possible

[01:11:24] now might not take nine months it might actually depend on your data. Well you know they've been

[01:11:28] trained by the programming of pharmaceuticals to you know get shot feel better right yeah and as

[01:11:34] Americans we want every media application you know as you know as you know as you know as you

[01:11:37] know as you know as you know as you know as you know as you know as you know as you know as

[01:11:40] dopamine dopamine dopamine right and I tell people all the time I said please put yourself in the

[01:11:45] mindset of are you willing to give up swinging the golf club for three months right give me three

[01:11:53] months expectations so that your swing will be better for 10 or 15 years can you do that yeah if

[01:11:59] you can't let me just give you your money back and go home you know I get people refunds all the

[01:12:03] time if I think they have it for if they have like crazy expectations and they feel like someone

[01:12:09] guaranteed them something I said listen there's no guarantees yeah for some people this does not

[01:12:14] work the only thing that doesn't that works for everyone is if you stop breathing you die I used

[01:12:19] to say everyone had to pay taxes but certain people with last names they don't have to pay taxes

[01:12:23] please adopt me so I will yeah you know if someone comes down and there's like no one told me it's

[01:12:29] gonna it was gonna hurt I was guaranteed this is gonna work I thought I was gonna be back on the

[01:12:34] mat in 10 days yeah I said listen let me just give you your money back right now I'll send

[01:12:39] you home and because that's not gonna happen yeah there is no guarantee yeah no it's fair

[01:12:46] no I appreciate that yeah I didn't know how many how many times your phone ring

[01:12:49] going into the CPI so I won't put myself I'm gonna say I'm feel you know 40 times four that's 120

[01:12:57] I've already treated probably 2,000 patients only half of them watch this that's a thousand

[01:13:03] plus another hundred and twenty phone calls a week I don't want to kill you you know fair fair yeah so

[01:13:10] we get we get two to three thousand phone calls a week for treatment yeah let's not uh let's not

[01:13:15] put that out there we won't um we won't answer any of those calls or emails yeah can we have

[01:13:20] your personal cell phone number please doctor no and thank you guys I really appreciate your time

[01:13:26] I know you guys are doing amazing things I just want to share it with the world and you know

[01:13:30] really help other people I think that I think the ratios they could be 50-50 in terms of you know

[01:13:36] how important is this stem cell how important is rehab in either case it's a large percent and

[01:13:42] we have a big role to play and the role that we're currently playing is we don't know what to do

[01:13:47] so we push them we have more stress and we flare them up I think that if we just understand

[01:13:51] the cruise control a little bit don't flare them up you have a baby growing in there a

[01:13:56] little baby cells growing in there your job here is not to drink the wine in the first three months

[01:14:00] it's to really allow that healing to happen maximize the the healing time and just allow them to have

[01:14:08] a little bit of freedom and independence in their own recovery because you're right if they say the

[01:14:12] physical therapist is gonna you know push me they have to have their own independence to be

[01:14:17] able to say like that doesn't seem right with what I've read and what I've seen and we don't

[01:14:22] have to just listen to the doctor you said before we're partners in this yeah yeah I chose to have

[01:14:27] this procedure and I selected you physical therapist so therefore I'm going to use your knowledge to

[01:14:33] make the best decision for myself especially when that physical therapist doesn't know what to do

[01:14:37] now it's a partnership versus healthcare it's like doctor patient in a lot of things that we do

[01:14:44] the reason why we get the outcomes we want is because we're partnering with people I get

[01:14:47] you want to do that I'm gonna barter with you I get it you you don't want to golf

[01:14:50] you want to golf next month how about we golf in four weeks or four months because you're not

[01:14:55] willing to sacrifice that if you can wait three months I can promise you you're gonna have better

[01:14:59] outcomes at 10 so the physical therapist out there to work and partnering with your patients

[01:15:05] this is not top-down approach that's pretty old school especially when somebody selected to

[01:15:10] have this procedure you're not telling them what to do you're helping them get to where

[01:15:13] they want that is a big takeaway so appreciate your guys's time anything to say to physical

[01:15:19] therapist out there before we head out there what would you tell them or

[01:15:24] thanks for taking care of my patients you know do the best that you can with them feel free we you

[01:15:29] know anyone can contact our aftercare apartment who's a physical therapist and will do our best

[01:15:34] I you know I think this podcast was an excellent idea thank you for making the time coming all the

[01:15:39] way down to Tijuana you know I'm happy you didn't get kidnapped or be hanged I have to drive home

[01:15:46] you know happy to take you out some of the best tacos you've ever had anywhere on this planet and

[01:15:53] you know and thank and thank you guys sports performance for what you've done

[01:15:56] you know you've done for me your team really is awesome it took Dom twist in my arm a little

[01:16:01] bit to get me to come see you guys because I had done so much physical therapy and none of it was

[01:16:07] successful and I I bring you guys up every week I talk come in I do a little bit of a

[01:16:14] Q&A with the patients and I explain my my process and my experience with you guys you know when

[01:16:22] when I blew out my knee grade two meniscus tear 50% PCL and I went in to see you guys

[01:16:28] I remember I think I only went like every two weeks because I was crazy busy but I was doing

[01:16:32] my exercises at home you guys gave me the rubber band which was super cool and I have to go find

[01:16:36] to buy one you know like that physical therapist yeah if you don't give your patients the

[01:16:41] tools you know for me like I probably never would have gotten one if you guys didn't say hey this is

[01:16:44] part of the deal I'm just that busy and that's stupid but you know just I think that you know

[01:16:54] you guys took the time because my knee did get I remember one time one of your therapists over

[01:16:59] there was like this is probably like my third or fourth visit pulling on my knee and they were

[01:17:03] like I never seen a knee tighten up this fast like this is crazy you know what I mean and

[01:17:11] and I was super happy with the results that I was getting from from doing that and so having them

[01:17:19] you know like they noticed it right they remembered me from all the different I'm a little

[01:17:24] memorable maybe but you know all of the different times and for them to you know actually and maybe

[01:17:30] you guys keep notes or I don't know how it works but to notice the difference that in just two months

[01:17:34] where my knee was sliding so far forward before if I held my leg up like this it just dangled

[01:17:40] you know uh to you know that tightening up you know that that type of attention to detail

[01:17:46] physical therapists you know it's what we all want yeah it's what every one of your patients

[01:17:50] wants and you know Lola and I we didn't get into this for any other reason is that

[01:17:57] you know we saw people get better we want we wanted to get better and I want every one of

[01:18:04] my patients not just my patients you know there's lots of great stem cell places yeah of course

[01:18:07] out there we're not the only one there's tons of places doing good work and this is the next

[01:18:13] generation of medicine so get ready for it now yeah because it's coming if you want to be a

[01:18:18] head of the head of the game you know there's going to be a day where stem cells is the first

[01:18:23] line of option before surgery that's a good point actually yeah we talked about that on our call

[01:18:31] and setting this up is that it's inevitable that this is the future of medicine so to have

[01:18:38] for our patients to have partners on their journey because it is such an integral part of healing

[01:18:45] it's amazing and the worst thing for a patient after you know coming down here having amazing

[01:18:52] result and knowing that physical therapy is an important part and then going to a physical

[01:18:57] therapist wherever they are and the physical therapist not being open-minded and being like

[01:19:03] I don't know what this is I don't know what you got done I need the order I need the thing I

[01:19:07] don't know how to work with this I won't work with this and kind of rejecting the patient

[01:19:12] because they just they're not familiar and instead of educating themselves and being

[01:19:18] open-minded more than anything else and seeing the future of where medicine is going that that's

[01:19:26] discouraging to somebody on the healing journey of course we always are in touch and we just say

[01:19:31] just find a new physical therapist and they always do and they find the right person for them

[01:19:36] but if you're a physical therapist listening to this open your mind like the world is moving

[01:19:42] and the medicine is moving at a fast pace so be like Dr. Chris. No I appreciate you guys' time

[01:19:50] thank you to the listeners for being part of this yeah the thing I can walk away with is

[01:19:56] this is the future this is a big part of what will be seen anyways so either you stay ahead of it

[01:20:03] or you wait till it hits you and you don't know how to manage these patients and when you

[01:20:07] push patients away we've all had that feeling when somebody leaves you that's a horrible feeling

[01:20:11] you're like I could have done better and I'm telling you right now these patients want the top

[01:20:16] the best and if you will want to be the best and stay ahead of that and stay on the top line of

[01:20:22] healthcare you need to stay in touch with where we're going with stem cell treatment so thank you

[01:20:27] everyone for being on the podcast and we'll see you guys on the next episode. Take care.

[01:20:31] Thanks for tuning into the Sports PT Academy podcast it means the absolute world to me

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