Episode 12: Touchy Subjects with Mike Stella

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• Joe Gambino
• Joe LaVacca

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Summary
In this episode of the Beyond Pain podcast, the hosts Joe Gambino and Joe Lavaca interview Mike Stella, an athletic trainer and performance coach.

They discuss Mike's recent trip to Italy, his business called The Movement Underground, and his personal journey with pain and injury. Mike shares his experience of being an injured athlete and the challenges he faced in his recovery.

He also talks about the turning point in his journey when he started exploring manual therapy and movement as a way to improve his own pain and performance. In this conversation, Mike Stella discusses the role of manual therapy in rehabilitation and the importance of meeting patients' expectations.

He shares his personal experience with anger and how it fueled his drive to overcome adversity. Stella emphasizes the concept of being unbreakable and finding ways to move forward, no matter the circumstances.

He also highlights the value of hiring a coach and the need to blend different approaches to provide the best care for patients. Stella encourages clinicians to evaluate the downside of treatment modalities and to update the narratives surrounding manual therapy.

Takeaways
Mike Stella shares his personal journey of being an injured athlete and the challenges he faced in his recovery.

The turning point in Mike's journey was when he started exploring manual therapy and movement as a way to improve his own pain and performance.

Mike's experience led him to become passionate about helping others and ensuring that no one falls through the cracks in the healthcare system.

The interview highlights the importance of personalized and comprehensive approaches to pain management and rehabilitation. 

Manual therapy can be a valuable tool in rehabilitation, providing pain relief and altering a patient's frame of reference around their injury.

Meeting patients' expectations and providing a tangible exchange of value is important in the therapeutic relationship.

Being unbreakable means finding a way to move forward, no matter the circumstances, and consistently doing the work.

Hiring a coach can help individuals navigate their rehabilitation journey and find the most effective strategies for progress.

Evaluating the downside of treatment modalities and updating narratives around manual therapy can lead to more informed and effective care.

Chapters

• 0:00 Introduction and Background
• 9:42 Mike's Injury and Recovery
• 14:46 Turning Point: Exploring Manual Therapy and Movement
• 21:28 Turning Anger into Fuel for Progress
• 25:20 Being Unbreakable: Moving Forward in Rehabilitation
• 29:01 The Value of Hiring a Coach
• 35:16 Evaluating the Downside of Treatment Modalities

Transcript

Joe Gambino (00:01)
Welcome back into the Beyond Pain podcast I am one of your hosts Joe Gambino and I'm here with your other Joe as a host Joe LaVacca You can hit us up on Instagram whenever you'd like. We love to chat send us a DM My Instagram handle at Joe Gambino DPT LaVacca is at strength in motion underscore PT This show also live on YouTube cups of Joe underscore PT

And you can also find us, the beyond pain podcast on Instagram. And we are here with the handsome Mike Stella. He is an athletic trainer. he's a performance coach. he is also from New York. So we are, we are three people from New York here. I love it. We're also three Italians. Mike did tell us before we started this, that he feels like a fake Italian. Now we have to go in Italy.

Joe LaVacca (00:38)
Yeah.

Joe Gambino (00:54)
But we'll let Mike take the floor. Tell us a little bit more about you. Tell us a little bit more about that trip to Italy and we'll go from there.

Mike Stella (01:01)
Well, I appreciate the kind intro. Yeah, I did just get back from Italy, which was amazing. It was actually my honeymoon, which was super exciting. It was our kind of like bucket list trip made into a honeymoon, which was super fun. So we went to Venice and Rome and Naples, the Amalfi Coast. And we just kind of like, it was one of those vacations where I was like, I needed like four days off when I got back that I didn't get because I was exhausted. It was like averaging like 40 ,000 steps a day. We just were like, my wife and I, Kate,

Joe Gambino (01:11)
for us else.

Mike Stella (01:30)
who's also a physical therapist, go figure. But she, like, we just decided, okay, we're gonna just do, we're just gonna see all of Italy in four to, in like five days. That's what we're gonna do. Which wasn't possible. Right. But it was great. It was great. I got my steps in. I realized I am not actually Italian. I am a dumb American. That's what I learned. They are so much more cultured and classy. Although cigarettes are still very big over there. I was shocked to see that. A lot of people smoking cigarettes.

Joe LaVacca (01:37)
Well, that's a normal trip.

Joe Gambino (01:47)
Ha ha.

Joe LaVacca (01:54)
But they're natural. They're natural though, right? Or like some, yeah.

Mike Stella (01:56)
Right. It's like, yeah, it's like their bread is better for you. Their cigarettes are better for you. I'm like, I'm not sure that's really the case. But, well, I just was like, man, if I really want to be Italian, it's going to get like a Vespa so I could just go chow with a cigarette, like sticking out of my mouth. But it was awesome. We had a great time. And yes, I am an athletic trainer, by trade and ATC. Very proud of that. And, yeah, do my thing here at the movement underground.

Joe LaVacca (02:21)
And what is the movement underground like?

Joe Gambino (02:22)
Love it, Mike.

Mike Stella (02:23)
The Movement on the Ground is my business. It's my hybrid clinic slash gym, like performance training studio, which we just relaunched or upgraded our space in September. So we're still, like we were doing really well with the therapy side, and that was kind of always our bread and butter and like renting space out of other gyms like a lot of us do to get started with our clinic businesses. And then we decided to take the plunge and jump into the performance arena as well.

So we have a couple of strength and conditioning coaches on staff that helped me run and implement, you know, like the integrated training and rehab programs. We've got like a little recovery lab that we call it. We've got infrared sauna, red light therapy, cold plunge, you know, so it would try to have it be that one stop shop. It's about 4 ,200 square feet. So it's not huge, but it's way bigger than, you know, what we were in prior. So it's exciting. It's really a lot of fun.

Joe Gambino (03:18)
4 to 200 square feet in New York, maybe not so much on Long Island, but that's a good amount of space, you know?

Joe LaVacca (03:22)
Yeah.

Mike Stella (03:25)
It's a good, I mean, on Long Island, it's expensive too, you know, so it's New York prices, but you know, again, some, you know, I gotta take the risk sometimes, you know, as uncomfortable as it was, was, you know, my sublease was ending and it was just like, okay, do I just go for another sublease and do this again? But I didn't really like where I was at because it was kind of like a toxic environment. I really wanted a little bit more control over, you know, the whole experience that, that my clients and athletes and, and, and guests have. So,

Joe LaVacca (03:25)
Yeah.

Mike Stella (03:53)
we decided to go for it and take the plunge.

Joe Gambino (03:57)
Very nice.

Joe LaVacca (03:58)
Yeah, it's an absolutely beautiful, beautiful location. And speaking of rent, the craziest thing since I've been going back and forth to Colorado is realizing that Courtney for, you know, and Total Health Solutions where Courtney is, she pays about the same for probably almost an equal size space that you have Mike, that I pay for a I think eight by eight space that I have where I can like reach out my hands and, and touch the walls. And I'm getting a deal I feel like.

Mike Stella (03:59)
Hmm

Joe Gambino (04:20)
Hehehehe

Mike Stella (04:22)
and touch either.

Joe LaVacca (04:25)
You know, I'm like, Whoa, I can't believe I'm getting this deal for this eight by eight space. Then I go to Courtney, who has like a warehouse and a gym. And she's like, yeah, I think we pay about the same each month in rent. And I'm like, well, we're both getting deals then I'm really happy for us.

Mike Stella (04:37)
You might be getting a better deal, right? It might be a better deal out in Colorado. That's awesome though.

Joe Gambino (04:38)
That's funny.

So Mike, I have one question for you before we get to the main content today and somehow we have a coffee theme on this podcast here. So first question for you is how do you take your coffee?

Mike Stella (04:58)
I take my coffee. Well, I take it two different ways. My first cup of the day is a cappuccino. Usually I have an espresso machine at home that was actually given to me by a former client who's an NBA player. And it was like we used to work together over the summers. He's a local guy from Long Island, Tobias Harris. And we, so it was the end of the summer. He was heading back to training camp and he gives me this coffee machine. I was like, and I,

Joe Gambino (05:07)
Hmm.

Mike Stella (05:28)
you know, I didn't know that it was a thousand dollar coffee, like espresso machine. I had no idea. You know, I'm like, man, that's really nice. Thank you. Cause I always had like a Starbucks cold brew, right? Which I drink, which I drink black. So he gives me this machine. I didn't, you know, he leaves. And then I like looked it up on Amazon later and I was like, holy fuck, this is a thousand dollars. Like that's insane. So that was really cool. So I make a cappuccino in the morning. and then I have a, I'm a little bit of a coffee snob as well. So in the facility, we have a smeg.

Joe Gambino (05:45)
Yeah.

Mike Stella (05:58)
coffee machine. You ever seen those before? So it goes bean to cup. So you just put the whole beans in the top with the water. It grinds it, it tamps it. It's like, you know, it's got like a little barista inside the machine, I guess. And then it pours you you could do a ristretto, you could do espresso, or you could do just a full draw. But this is black, plain black coffee. That's it. Fantastic.

Joe Gambino (05:58)
they're fancy. Mm -hmm.

I'm a little, little envious over here. Not gonna lie.

Mike Stella (06:22)
Hey, listen, if you guys want to come lift, you're going to come work out and, and grab some coffee, man. Like I said, it's, I'm trying to build a one -stop shop. So there we go.

Joe LaVacca (06:22)
I told you, Joe...

Joe Gambino (06:29)
When I'm back in New York, I know my first stop now, you know? I actually just shifted to cold brew season. I make my own cold brew here at home. And that's, so now we're in a good spot.

Joe LaVacca (06:32)
Man.

Mike Stella (06:38)
I never had success making my own cold brew. Like I do it, I've done it. I've done the mason jar version. I bought the special thing for making cold brew. And like, you know, when you drink like a, like a really good like stump town cold brew or something like that, and it's just like, my God, it's like, it's, it's almost so good that it's sweet by itself. I have never ever been able to reproduce that. It's so disappointing.

Joe LaVacca (06:53)
Sure.

Yeah, I guess we have high standards, Mike. And I was telling Joe, you're really you're classing up the whole podcast already. I mean, you're dropping coffee names I've never heard of. We got multiple camera angles. I mean, this is this is really, really great. Really. There it is.

Joe Gambino (07:03)
Yeah.

Mike Stella (07:04)
I don't know, maybe.

Right. Right.

Joe Gambino (07:17)
The six people watching this on YouTube are gonna love the camera change right there.

Mike Stella (07:22)
Yeah, I'm a nerd. I don't know. It's just, it's who I am.

Joe Gambino (07:27)
I think we all are here, right? I mean, that's why this podcast even exists in the first place. Just straight up nerd out.

Joe LaVacca (07:33)
That is true. That is true. That is true.

Mike Stella (07:36)
Well, I appreciate you guys inviting me on. This is awesome. It's always good time talking with both you guys.

Joe LaVacca (07:38)
Yeah, no, no, no, no, no. Yeah, and as Joe was saying, like, one of the biggest reasons that the podcast exists is, you know, as the name states, to help people move beyond pain. And one of the things we really wanted to highlight with clinicians like yourself was their personal stories and experiences with it. So one question I really have for you, Mike, knowing a little bit about your injury history, which if you're comfortable sharing with people, we'd welcome that. But,

Joe Gambino (07:41)
Absolutely, man.

Mike Stella (08:05)
Yeah, yeah.

Joe LaVacca (08:08)
What is your pain story or current relationship with pain?

Mike Stella (08:15)
Well, the last couple of days I have this crazy stiff neck. I posted on my stories and Instagram the other day. I was like, I can't like I barely turned my head to the left. Although I did just get some treatment. So I'm feeling a little bit better. Luckily I know some people, which is nice. But my pain story is kind of the classic athletic trainer story is I was an injured athlete. I played lacrosse in high school. Well, I played a lot of sports. I did football, track and field, bowling, lacrosse was like the big four sports for me in high school.

And I was really good, but I was a good athlete. I wasn't necessarily the best lacrosse player, like, skill set wise, but I was a really good mover. And so I think at the time, I wasn't training at any special facility or anything that I could run like a 4 '6", 40, 4 '5", just under 4 '6". So I could do a lot of stuff with my legs and make a lot of things happen. And so I started getting a lot of attention, like college recruiting and...

you know, started believing the hype a little bit. And then, and then I blew my knee out. So I, it was a collision injury. I tore my ACL, PCL, MCL meniscus and had a tibial plateau fracture. So I basically dislocated the knee. and that was really my introduction to really athletic training and sports medicine and physical therapy as, as even a potential career. But I think really, you know, and it was the classic surgery rehab.

I went to Marist College to that was the last D1 that was going to offer me any scholarship money. And I, what I then developed was a really insidious relationship with pain and movement because all of a sudden I was like the man on my high school team. And then obviously that season got derailed for me by the injury, but all of a sudden now my next, you know, basically opportunity to play is division one lacrosse with a lot of really good talented players. So it wasn't,

It's kind of like the big fish in the small pond and I hear the small fish in the big pond, but not only that, but like my one key attribute, which was my legs was kind of like not there. You know, I never really got into the strength and conditioning, maybe the way that I should. It was kind of obsessed with, okay, six months, I'm going to go back. And I played hurt and like I still had swelling knee contracture daily. You know, I was, I was like hobbling around. It just led to a lot of other injuries.

But more importantly, it kind of led to an identity crisis for me. So I was really depressed. I struggled with anxiety, like performance anxiety. I was so worried about, do I belong here? What do my teammates think of me? Is this coach who took a chance on me to give me scholarship money disappointed? It was just a lot of the internal struggle is kind of what became my why for getting into this career, because I feel like I slipped through the cracks.

in the healthcare system. Because what happened was every time I would go to the athletic trainers at my school, because I didn't get hurt at Marist, they were bootstrapped a little bit. They're like, well, we really can't, quote unquote, take over your rehab because you didn't get hurt here. And so a lot of it at a mid -major level is a resources issue. So not to blame them, but they were helping me just not in a more in -depth way. And then for strength and conditioning, it was like,

you're on your own kid, like, you know, do your basic program that you had from your PT back home. And I just never really got there. So that kind of became my why is like, nobody's going to fall through the cracks on my watch. You know, if there's something we can do, I'm going to figure out a way to get it done or help this person move forward. But, you know, that that really became the, you know, the, the ethos, I guess, behind why I do what I do and how I got to where I am now. It's like I joke, but it's like I became now I am the person I needed 25 years ago.

That's kind of what happened for me.

Joe LaVacca (12:09)
That's a really interesting way to put it, because that's actually what I was kind of thinking. Like your story and your experience has set you up to be so successful now with a lot of your clients. And that word identity that you used, I really appreciate that because I think that's where a lot of people's stories end up for me. And I kind of take leaps with that. It's sort of, I hear you and it sounds like you don't have that purpose or that driving force.

Mike Stella (12:20)
Right.

Joe LaVacca (12:39)
So when you were going through that, what was the biggest thing to help you kind of like shift back your focus onto who you were and find your strengths again? Was there a person, a mentor, a moment in time for you that kind of helped you refocus and shift that perception?

Mike Stella (12:56)
You know what it was man, I think I think in my college years I became so disheartened and like Like I really did struggle and and again at the time if you would ask the college version of me or like are you depressed right now? I'd be like, no, I'm good. But like looking back on it now. It's like, okay, I was ruminating over it. I was like

I started becoming obsessed with figuring out why I couldn't reach my prior level of performance. And so even for like, it really wasn't until graduate school, right? So I, so after college, I worked for the university of Florida in their sports medicine department, which was an amazing experience. I got to work, I call it sports medicine in a bubble because there really is no budget or financial restrictions. It was whatever you need to do, you do for your athletes and give them the, give them the care of the time.

You know, we had a lot of resources, financially, equipment. Like, I mean, again, it's just whatever you need to do, you do. So that experience kind of like started getting me back into, okay, well, maybe what I've been trying is only scratching the surface of what I could have done or could do to get my body back. And so a lot of what I was learning at that time, or even continuing education wise, was truthfully very selfishly motivated.

to try to figure out my own issues. I mean, dude, I'm talking like four years after my knee reconstruction, I still couldn't straighten the knee all the way or really flex it all the way. I was still having chronic pain and chronic referral pain even down to my ankle. Like I had a saphenous nerve entrapment. My knee was a freaking nightmare. And so again, I just always was trying to like work around it. I was very afraid to load it because everything I had been told prior to that was,

You gotta be careful with it. I had a experimental quote unquote procedure for the knee because I tore, I was ACL and PCL compromised. So for me, it was just a lot of fear, a lot of anxiety, a lot of depression and really just like a dark place. But in that dark place kind of was the seeds of the obsession, I guess, with movement. And then that parlayed into the obsession with like manual therapy stuff.

because my boss at Florida was like, dude, your scar doesn't move. Like you got this, you got that. And he started working with me. And all of a sudden I started seeing more progress over those few weeks working with Andy than I had seen in the previous four years. And I'm like, what the fuck? Why didn't anybody do this with me? I was pissed. I was really pissed. But that started getting me back into fitness a little bit. I started working with the strength coaches at Florida a little bit more.

And then my graduate work was all, I was just obsessed with manual therapy and strength and conditioning and movement and biomechanics and like a lot of that heavy mechanical stuff because I was like, there was so many things that I could have done that I missed that no button that all the people I went to missed also. And it, and it really, it pissed me off. I mean, I was just angry. I was an angry chip on my shoulder, something to prove. I felt like I had been cheated.

So a lot of it was just wrapped up. And that obviously manifested into my personal life as well. I was very distant in my relationships, isolated myself a lot. And so people ask me now, hey, Mike, what do I have to do to learn and know what you know? I was like, are you willing to sit in a dark room with a single exposed light bulb with water dripping down and just be in a dark place for a decade? And that dark place for me was reading research and taking courses and trying to invest in.

like understanding that there's a lot more to this than just like your basic therrex exercises and like stim and ice, you know?

Joe Gambino (16:48)
That's a hard story, right? You obviously overcame it. You're in a great place now and I think there's a lot of good that came from it, not just for yourself, but the people that you work with, right? Do you feel like that the turning point was when you were working with that guy at the University of Florida? What do you feel like was the turning point for you where you were like, well, now I start to feel like I'm on the right track. I'm feeling better. You get out this dark place.

Mike Stella (16:59)
sure.

I would... yeah.

He, Andy Clark, opened up a whole world to me that I had previously been very closed off to. Because again, I don't know how it goes in PT school, but at my program at Marist for Athletic Training, which used to be an undergrad program, so you can get your ATC license with a bachelor's degree at the time. Now it's a master's degree. But at the time, we looked at manual therapy as almost like, we don't do that.

you know, that's like you go see a massage, you want to massage, you go go see a massage therapist, like we're not going to rub you, we're going to do like stim and ultrasound and like cool modalities that they can't do, you know, and it's like, such bullshit. But so I had almost like this, like, I don't know, like this air of superiority that like, putting my hands on people was like below me at that point. And then I get to Florida. And the mindset there was, they were like, okay, well, what kind of, you know,

manual therapy experience do you have? And I was like, I know what effleurage is. Like, that's about it. And he's like, okay, great, perfect. We call that a flush and you're gonna do that 50 times a day on these track and field athletes. And I'm like, okay. And like, and I'd be on the other table. I wasn't even allowed to work with injured athletes yet. And I'm looking at him, like working with these guys and like completely changing their movement, like instantly with his hands. And I'm like, what the fuck is that?

I'm like, why didn't I learn that in school? That's insane. Like, I just watched him improve this athlete's hip mobility, completely erase this dude's pain in minutes. I'm like, OK. I'm like, I already was skeptical of what I've been taught because I clearly couldn't get better. I'm like, OK, this is what I need to learn now because that's clearly the direction. And again, even at that time, this is like in the mid to late 2000s, right? So that was before kind of all the, you can't break stuff up. So that was a lot of.

what we thought and what we were doing and using tools. And it was just super cool for me. But yeah, that was the turning point because I think that was the moment I realized that school did not teach me everything, that there was still a lot that I had to learn. And I was just like, great. Thank God. Because if this is all there is and I can't get better, what hope do I have to help other people? You know?

So that was kind of like where I became like the con ed junkie. And then those things, you know, again, helped me figure out what I needed to work on.

Joe LaVacca (19:45)
Yeah, I think that even your story around manual therapy too, Mike, I really appreciate, especially in today's social media environment, both as a clinician and a patient. Because I think that there's such this dichotomy where if you're going to a provider who's doing manual therapy, you should not be getting manual therapy. You should be loading it and exercising. And if you're a clinician, don't take manual therapy courses. Don't do this. Do something else instead.

Mike Stella (20:07)
Right.

Joe LaVacca (20:14)
And I think your story just reflects like that there's a harmony there. And I think that how we've even spoken about manual therapy here on the show, which Joe can't even do because he's all virtual now, right, is is essentially using it as this like diagnostic, using it as an assessment, using it as just a way to connect with people. Right. I mean, when people are bringing so many things to the table and you've shared your emotions, and I'm sure your athletes and your clients do the same thing.

to just be able to put your hands on someone, move it around and say, hey, I think you're gonna be okay, and this is what we need to do, and this is what I'm feeling, I think gives a lot of reassurance. But one thing I wanted to just ask you quickly with this whole like anger thing, right, which makes sense to me because, you know, that's, you know, a feeling of fairness, right? You have a sense of right and wrong, you know, justice comes to mind with all this like anger, right? And it does seem like you were not given what was right, right, during your rehab process, but anger can be such a powerful emotion. How did you...

turn it into good. And what do you think was the driving force behind that? Why didn't you just like, you know, go to the bar, put on your Florida Gator t shirt, and then, you know, never leave.

Mike Stella (21:28)
Man, that's a really good question. I think that kind of starts going down like what I was dealing with personally, like family -wise at that time. My mom was sick with cancer at the time. So immediately it was, even my siblings, whom I love, weren't really in a head space to help her. And so for me, it was get back to New York.

and have to be the hero and a lot of not the hero, but like, I had to put all my own shit aside and just get shit done. And so it almost, and again, I look back on it now and it's like, maybe that's not the best coping mechanism to deal with your own depression. But what it did was kind of completely put the blinders on for me for everything that I was dealing with. And it allowed me to just execute for somebody else.

Right. And so I think that's part of like what we all do with our patients sometimes even right is like, maybe we don't have all of our own shit figured out, but we can be this person for somebody else a little easier sometimes than we can do it for ourselves. Right. So I think that was part of it for me was, I had to serve my family. I had to serve my mom and help her. And a lot of my own anger just kind of became, like nobody's going to be able to help me. Nobody's going to.

give me a leg up, nobody's coming to my rescue. So the anger just got, it just became the motor. It became the gasoline and the motor. It just is what drove me. It was like, I have to learn more. I have to be the best. I guess I'll just switch to camera two. I don't know why that happened, but I had to be the motor. It had to be me that was going to get it done. And that's kind of what happened. It was just,

Again, I don't remember being quote unquote angry, but it's like really the only way I can describe like the chip, the chip on my shoulder. Like I had something to prove. I had to prove everybody wrong that I could, you know, be an athletic trainer and, you know, make a good career out of it. And then even at that time, like I kind of started realizing, shit, like how am I going to survive on 30 grand a year and work 80 hours a week?

You know, like that's kind of where I was. I was bartending on the weekends to like fund my career, even though I had two master's degrees at that point, you know? So it was just that those late 2000s were just like a super dark, dark time. I don't even really remember a lot of it, to be honest. I just worked a ton. You know, anytime I wasn't working, I was trying to help out my mom. And then when I wasn't helping her, I was sleeping. So it was just like no time for anything else. And maybe that was my saving grace. I didn't really.

adopt any like self destructive stuff. You know, I was just kind of like out there doing what I had to do.

Joe Gambino (24:22)
Yeah, that's, I mean, I already say kudos to you because I think in situations like all this, right? It's like two ways you can respond. One is like retreat, right? And then play the what was me card or to go out and kind of attack and put that chip on your shoulder and make the changes that you kind of need to write and put yourself in a better situation. So I think it's, it's, it's pretty cool. I didn't know really that much, you know, about any of this stuff, right? Before we had this conversation. So it's cool to see, you know, I mean, I have a similar story with my back pain and kind of want it to get better, but I don't feel like it's any.

as deep as this goes. But I do want to switch gears here just a teeny bit. I kind of want to bring in like a little clinical question here and just kind of revolving around the same theme of manual therapy. Because I think we all may have slightly different rationales for why we may have used it in the past or how much we use it. I know for me personally, when I was in clinic, maybe it was like 10 minutes at most I ever did for manual work in a 60 minute session. I did it.

kind of like Joe said for diagnostic reasons and also kind of like builds trust in my eyes as far as like connecting with the patient showing that like, I think there's a therapeutic touch to touch in a sense, right? Like you make them feel a little bit better just by putting your hands on and then you go loaded afterwards. So what is your perspective, I guess on manual therapy and how do you feel that that ties into the whole like your strength and conditioning background and everything that you do?

Mike Stella (25:47)
Yeah, I mean, again, I think now is is how I'm using it the way that a lot of us that have kind of followed the evidence and understand, OK, there's maybe more to this than the mechanical. Right. So like when I first started, it was all mechanical. We're breaking up muscles, we're lengthening stuff. I'm remodeling tendons. I'm realigning fiber blast, you know, fiber blasted collagen production and all that kind of stuff. And then like as I kind of look. But again, we were getting results, you know, and at the time and the mindset at.

in the SEC, right with those athletes was results by any means necessary. So like for me, like working with athletes exclusively and seeing the results in the, you know, again, a lot of that is how quickly can you get somebody to a level that they, they can go out and perform. So, you know, manual therapy has a lot more efficacy in that type of situation where it's not as much of a time factor or insurance billing it or.

Joe LaVacca (26:17)
and

Mike Stella (26:42)
you know, the other variables that maybe influence how we use specific modalities or tools. You know, fast forward to now as a business owner, and I really like getting hands on with people because, you know, as we've learned more about, you know, the biopsychosocial model and, and I think, you know, we can't break up tissue, right? I think what's happened is a lot of, a lot of clinicians have taken that as a reason for not doing manual therapy.

It's like, OK, we're going to pain science. Pain's multifactorial. There's more to it than just breaking up tissues. But I think kind of what happened is we started throwing the baby out with the bathwater and not realizing that when you're providing a service to somebody, there's a certain degree of expectation that comes with somebody seeing us for service. And that's kind of what I think to now is like,

Are, is this person's expectations of care being met? And I think a lot of times if we're just, hey, here's a program, here's what you need to do from an exercise perspective and get stronger, which is awesome. And I believe that. And I know that that's really where the progress gets made. But what I look at, I look at manual therapy now as the exchange. That's the exchange. If I'm gonna ask somebody for money and I'm gonna give them my time and my expertise,

we have there has to be some kind of tangible exchange, not just a piece of paper with exercises on it. Right. And so when I make this joke, and I'm very demonstrative about it is like if you had a huge plumbing issue in your house, and you called a plumber, and he came to you and gave you the step by step instructions on how to fix it yourself, and empowered you to do it, you'd be fucking pissed. Right? You'd be absolutely furious with that person.

So it's like we expect as therapists for people to come to us and just listen to our instructions. And I feel like when I'm treating somebody, that is my opportunity to provide the context behind the instructions and as well as give them the perception of a value exchange. It's like, okay, I'm paying $200 for this session with Mike and I got something from it. Mike gave me something, right? My energy, my time, the experience, which again is 99 % of the value.

But we also have to understand the person's perception of value. Right? So my session in an hour looks like 30, 30, 30 minutes manual therapy. And in that 30 minutes, I'm strategizing, I'm asking them about their life, hey, what's going on? Like, it's sometimes it's a little bit more social and just us having a good time and having and reframing a rehab experience around a pleasant experience. Sometimes it's us kind of like digging deep and it's deep patient education stuff, pain science stuff, movement science stuff.

you know, progressions, regressions, modifying lifestyle, you know, maybe we're tweaking things in their program. And then, and then there's the actual physical part, which is I can change context of tissue, neurologically speaking. And if maybe I'm not doing it from a mechanical perspective, like we used to think at the very least they see a difference. So what does that do for the frame of reference for somebody?

experiential, like experience wise, their frame of reference around their injury or their condition now is completely altered, just like mine was 20 years ago, when Andy put me on the table, and all of a sudden, I can straighten my knee all the way for the first time. And I was just like, my mind was blown. I was, yeah, I was pissed that I hadn't gotten there sooner. But I was just so incredibly grateful that somebody was like, Hey, man, did you try this? Let's do this.

And I think that's part for me now. I'm even just getting emotional just thinking about it. But it's like, the part now is I get to give that to somebody, that experience. So you can say manual therapy sucks, all this bullshit. But the reason it's impactful for me is because it was impactful for me. It helped me turn the corner. That's the part that people don't get. But again, I think, and part of what I'm trying to do with my new course that I'm releasing this fall is, I think the people who have a heart

problem with manual therapy, it's not so much the practice of it, it's the narratives that get wrapped around it. So so kind of my goal for my next course is like, and again, I'm going to call it an evidence based manual therapy course. And part of that's the marketing part of it is like, fuck, evidence based manual therapy is like, is that a thing? Because everybody thinks it's not a thing. But it's just like, look, let's update some of these narratives. So we can have a conversation with people like this about what it actually tangibly can do, and what it isn't doing. And being honest about that.

And then honestly, people appreciate that. Hey, you don't need manual therapy. I tell every, before I even swipe the card, you don't need treatment to get better. I can coach you to get better, but it can help a lot. So I like to use it because it represents a bit of a turbo button.

Joe LaVacca (31:40)
I love that Mike. Thank you so much for sharing that. Thank you for being passionate about it. I don't think we can put three Italians on the show anymore. There's too much emotion and hands and everything, you know? No, man, but I mean, what do you...

Mike Stella (31:46)
Hehehehe

No

Right, right.

Joe Gambino (31:54)
Well, I was literally just going to say, Mike, you are a town in my book. I mean, if you're watching this on YouTube, those hands were going on that. That's a natural inclination for Italians with your hands. We speak this way, you know.

Mike Stella (32:01)
I didn't even notice it yet. If I had to sit on my hands, bro, I wouldn't be able to get a word out.

Right, right. Now I'm all self -conscious, I'm gonna sit on my hands, I'm like not gonna be able to speak any words.

Joe LaVacca (32:09)
No, man, I and I know I try I try to I try to cross my hand sometimes I don't knock the mic off my table. But no, I really appreciate your viewpoint on that. And and I think to me when you share that idea of like the plumber coming over and say, Hey, I can show you how to fix this. It's like, no, it's not. It's not what I hired you for. Right. So I think setting that expectation. And I love that word to like in care, like seeking people like what do people want? Right?

And that's the thing I've tried to learn over the years is, you know, I think I sometimes got too, too handsy in the beginning of my career. Like I just assumed people wanted manual therapy from me. And then after a couple of sessions, it was like, hey, look, well, what, why are you here again? What did you come in for? And they're like, I just wanted you to tell me I was okay, and that I could move and, you know, teach me a little bit more about pain. And I was like, Whoa, I have not been doing that. So I think that expectation factor is really, really important. So thanks for bringing that up, man.

Mike Stella (32:55)
Right.

And that's kind of like, you know, meeting people where they're at, right? You know, cause some people like I get, I'll get some clients every now and again, that it's like, you really don't need any manual therapy. I mean, we're going to do a little bit of it because it's part of like what you're expecting. Cause you've done your research about what we do, but it's like, we're going to spend most of this time moving and teaching you how to move, you know? So again, it's not like 30, 30 always. It's like, that's, I kind of like the ability to, you know, sometimes do more of it, sometimes do less of it. And then the whole, the whole.

program is guys around like, I'm going to over the next eight to 16 weeks, we knew off of me so that you can be completely sustainable on your own. And it's like, wait, what people can have autonomy and, and, and sustainability and do manual therapy. It's like, yeah, they can coexist. It's like, well, cause some people just like the treatment part. I have clients that come just exclusively for manual therapy because it's now become part of their self care routine. It's become part of.

You know, they genuinely enjoy the interaction. They enjoy the time on the table. They feel better. They feel like, okay, I'm good for to train this week and I'm not going to get hurt. It's like, and it's like, we got to remember it's like, yeah, what people want, what they need. And our job as a clinician is kind of blend those two things together so that they're so that they're getting what they need when they need it at the time that they need it. And then we can kind of show them that progression.

Joe Gambino (34:30)
I love that. I really resonated with throwing the baby out with the bathwater analogy there because I think our industry, right? Like we've shifted so much once the research came out that we can't make tissue change, right? With our hands. Everyone's like, you don't need manual therapy anymore. But we neglect the fact that like it actually does something right, whether it's from a neurological standpoint or some other reason. So I think having that combo of manual therapy with, you know, the loading portion of things is extremely powerful. And.

You know, I think the other reason why PTs and people in our industry are cautious with it or they say don't do it is because you don't want to create that reliance factor. But if someone wants to do it from a recovery standpoint, because they enjoy it and they want it as part of their self care routine, like why, why stop them? You know, it doesn't make any sense.

Mike Stella (35:15)
Right, it's like there's so many more harmful things that they could do, you know, to recover faster. It's like, yeah, go ahead and take some HGH. Like you could do that. That'll help you recover, right? Evidence -based. But there's certainly some more downside than getting a massage a couple of times a month, you know, or getting some, you know, soft tissue or instrument work. I always, that's one of the other things too. It's like, I always try to evaluate downside when it comes to like a treatment modality. I think a lot of times we're always looking for...

Joe Gambino (35:24)
Hehehehe

Joe LaVacca (35:24)
Okay.

Mike Stella (35:44)
what does the evidence say? And it's funny because I actually literally just made a point, you know, post about this yesterday. And, you know, and I post a while back where I talk about, you know, I think people, the new shit talk, right on social media is like, I got an evidence, I got a research paper that refutes what somebody's claims are. And so I'm going to call you out and, and have this be some like confrontational conflict ridden, you know, people's negative and people just are attracted to that, which is crazy to me. But that's kind of what

people are into now is like, who's got the evidence? You know what I mean? It's like, you can go find research to support anything. You know, so somebody says, manual therapy is not evidence based. It's like, well, why would I mean, really? You're really just not you're really just going to refute the entire body of evidence that would be pro manual therapy. It's like, that's called confirmation bias, right? And research methods 101, we learned that that's bullshit, you're not supposed to do that, or cognitive dissonance, right? You're just ignoring what you don't want to hear.

Joe Gambino (36:21)
Mm -hmm.

Mike Stella (36:42)
And I'm not saying, okay, I'm going to put people on, you know, and again, I think part of it is there are the people out there who say, I'm gonna realign your spine and don't do anything and don't ruin this. And so those, that's the narrative, right? That I'm talking about that needs to be updated. And so I think what we're seeing is like this, the opposite ends of the spectrum kind of arguing with each other. And, you know, you had the Adam Meekins arguing with like, you know, the hardcore ART people. Cause I remember when I took ART, it was like, I resolve.

this condition in two sessions or less. And you're like, holy fuck. I'm like, well, I must be doing this wrong because I can't do that. And I'm like, I'm going to get to that point where I can resolve this. And I know some local providers who are like maybe some ART instructors and fucking great, great people, but believe that. But believe that they can fix people with their hands. And so I think that's kind of the argument is like, OK, maybe that is a little ridiculous. And it is. And I agree. But I don't think we just.

Joe LaVacca (37:12)
Yeah.

Mike Stella (37:40)
you know, get rid of the entire practice, you know, because there is a, it's a great way to help people that isn't drugs and it's not surgery, right? If I can give somebody some manual therapy for 30 minutes and it gives them some pain relief, even, even at, even to a fraction of the level of a cortisone injection, you know, knowing what you guys know about those things, what would you pick? I would pick the manual therapy. I don't want to blow out my Achilles tendon, you know, or degrade connective tissue, but.

Again, we have to always evaluate downside and I think that's just not something we do enough of. There's very little downside to spending that time with somebody and treating them manually, you know?

Joe LaVacca (38:18)
Yep. Yep. So with that being being said, Mike, what what would you say is your biggest piece of advice to your current injured athletes or to anybody out there listening who's maybe going through the experiences that you went through in high school, college, and maybe even beyond that?

Mike Stella (38:41)
The biggest piece of advice. Man, that's so hard, right? Because I think that changed me at different points in the process. But I think, like right now for the movement underground, our new tagline is be unbreakable. And I think, and when I tell, when I explain what unbreakable means to people, it doesn't mean that you don't have your issues. It doesn't mean that you never have pain or you never have an injury or a setback. It just means that no matter what happens, you move forward.

You find a way to move forward. Doesn't matter what it is. If you can't run, walk. If you can't walk, crawl. You know, if you can't crawl, roll. Do whatever you have to do to move forward because there is no progress standing where you are now. Waiting for somebody to come save you, waiting for some magical innovation to come happen, to fix whatever problem it is. It's like, you have to do the work. You have to find a way to do the work. And I think that is...

really the value of hiring a coach is like, I think a lot of people just get stuck in the minutia of trying to figure out and look at the research and what's going to get me better. And they miss the point that, you know, it really almost doesn't matter what you do as long as you do something consistently. So whatever it is, find that something that you can do consistently and just execute it day in and day out and progress it as best you can. You know, I usually, I tell people we're going to start with one linchpin at a time.

So I'm just trying to find what's the biggest ROI for somebody. Out of all the possible adaptations we could train for or treat for, what is the thing that moves the needle forward the farthest in the least amount of time? Whether it has a direct causative or correlative relationship to their current injury issue. It's like, what is going to give them the highest ROI in the least amount of time? And I'm going to start with that.

And then we can see how that affects their pain experience. Right, because we don't know. We don't know causative causal relationships for any of this stuff. It's like we're all just trying to limit variables. So I'm just trying to limit variables and find the variable I think is going to be the one that swings the biggest door.

Joe LaVacca (40:59)
Mr. Joe, you got any other questions for our boy here?

Joe Gambino (40:59)
Yeah, love them.

Only question I have left is well, maybe it's not really a question more of a statement directed at you Mike But tell the listeners where they can learn a little bit more from you and how they can they do want to work with you how they can find you

Mike Stella (41:17)
Yeah, I mean, I'm pretty easy to find online. I'm proud of that. So Mike Stella underscore ATC is where I'm at on Instagram and X or Twitter. The YouTube channel is The Movement Underground. Again, that's kind of where you find all my free content, which is all pretty much all my content's free right now. I'm working on some new courses so they can find more information on that, on my Instagram and...

The facility is located in Seaford, New York. So it's on Long Island. It's right on Merrick Road. So we're kind of like dead smack, almost dead smack in the middle on the South shore. So, but we also do virtual, you know, so if it's, if you think we're a good fit to work together, if maybe a specific sport outcome is what you're looking for, I think that's kind of like always been my wheelhouse has been like returning athletes to competition. I would say it's kind of always been my forte is finding a way to put athletes back on the field and.

do so sustainably. So, you know, we work, but again, we work with everyday people too. You know, I think if you can, if it works really well for athletes, it works really good for gen pop too. Maybe it's just a little bit framed a bit differently, but yeah, that's it. The movement underground .com or you can find me at Mike Steller underscore ATC.

Joe LaVacca (42:31)
Beautiful. Michael, thank you for your time, brother.

Mike Stella (42:35)
Thank you guys, this was fun. We'll do it again sometime. Cheers.

Joe Gambino (42:37)
That was great. We will definitely have you back for round two.

Joe LaVacca (42:39)
Yeah, we'll definitely need to have you back.

Mike Stella (42:42)
for sure. Say less, say less. I'm in. Even if you guys just want to do this and not and not put it out there, we'll just like hang out and just chop it up and just be like, I will fucking delete that file for the you. People like no.

Joe Gambino (42:45)
Permanent permanent spot on the

Yeah, I love it.

Joe LaVacca (42:53)
I'm good. I'm good. I don't know. I'm gonna come be working out with you soon. So we can just record our workouts and our conversations. Absolutely.

Mike Stella (42:59)
Yeah, let's do it, man. Let's do it, man. that, but the last time we did that, it was like, almost, we just like shooting the shit and we were like heart. We did like five sets.

Joe Gambino (43:06)
Yeah.

Joe LaVacca (43:08)
I don't...

Mike Stella (43:10)
But it was great. I was like, you know what? I'm just gonna do curls Joe. What else you got to tell me?

Joe LaVacca (43:12)
Yeah, but you know what? We worked hard during those five sets. That's all that matters.

Joe Gambino (43:13)
Yeah.

Mike Stella (43:16)
Yeah, 100%. It was a proximal failure, maybe the jaw working the most. But no, it's always a good time. I appreciate you guys. Thanks for both of you for putting out great stuff, great content. I think a little bit more positivity around, we have more in common, I think, across clinical backgrounds than we have not in common. And I think people just need to remember that. We're all trying to help people. Everybody has a different approach. It doesn't mean anybody's wrong or right.

Joe Gambino (43:45)
Absolutely, I know, I agree with you. And thank you Mike for your time and coming on the show. And as always, to close it out, guys, I love both of you and audience for those listening. Love you guys as well. And if you made it to the end of the episode and listened this far, extra love for you.

Mike Stella (43:49)
of any time, any time.

Joe LaVacca (43:56)
Love you.