Episode 29: Engaging the Process with Michael Ranfone

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• Joe Gambino
• Joe LaVacca

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Summary
In this episode of the Beyond Pain podcast, hosts Joe Gambino and Joe LaVacca welcome performance coach Mike Ramphone. The conversation explores various themes including personal growth, injury recovery, and innovative healthcare approaches. Mike shares his journey from suffering a life-altering injury to finding purpose in strength and conditioning, emphasizing the importance of mentorship and trust in the healthcare system. The discussion also touches on coffee preferences, business insights, and the evolving landscape of proactive healthcare. In this conversation, Michael discusses the importance of proactive health and wellness strategies, emphasizing the need for a shift from reactive healthcare to a more preventive approach. He shares his personal journey through injury and trauma, highlighting the mental resilience required to navigate these challenges. The discussion also delves into motivation and accountability in fitness, the significance of engaging with the process of change, and practical strategies for time management and skill acquisition. Michael advocates for a mindset shift towards empowerment and informed decision-making in health and wellness.

Takeaways
Personal growth often stems from overcoming adversity.

Injuries can lead to identity crises.

Strength and conditioning can help in personal development.

Mentorship is crucial for professional growth.

Trust in healthcare can be difficult to rebuild.

There are both good and bad providers in healthcare.

Proactive healthcare offers alternatives to traditional systems.

Personal experiences shape professional perspectives.

Community and support are vital in recovery. Proactive health strategies can
minimize reliance on reactive healthcare.

Mental resilience is crucial in navigating injury and trauma.

Motivation is demonstrated through action, not just intention.

Engaging with the process of change is more effective than blind trust.

Time management is a critical skill that is often overlooked.

Recording time can reveal patterns and areas for improvement.

Accountability is key to maintaining progress in fitness.

Nutrition and fitness should be viewed as skills to be developed.

Empowerment comes from taking responsibility for one's health.

Understanding where time goes can lead to better life choices.

Transcript

Joe Gambino (00:00.691)
Welcome back into the Beyond Pain podcast. I am one of your hosts, Joe Gambino, and I am here with Joe ready for the World Series Lavaca. This is going to be very outdated by the time this podcast is ready to go. But I am excited for the Yankees to get underway with the Dodgers today. And I know you are as well too, Joe.

Joe LaVacca (00:21.59)
That's right, that's right.

Joe Gambino (00:23.759)
And you can find us on Instagram at joe Gambino DPT for myself and at strength emotion underscore PT for Joe over there. And you can always find this show on YouTube cups of Joe underscore PT and on Instagram as well beyond pain podcast. We also have a very special guest, Mike Ramphone. He's a performance coach, massage therapist and founder of ran phone training systems and hand in.

Connecticut and it's been a long while he was on an old podcast used to run fitness for the fairways So he's back in action with us Mike. Welcome to the show

Michael (01:01.59)
What's up fellas, been too long.

Joe LaVacca (01:03.832)
Yeah.

Joe Gambino (01:04.187)
I know, really has been.

Joe LaVacca (01:07.628)
I think, Mike, the last time I saw you, we were in your gym. And every time I've seen you since, those biceps are getting bigger and bigger. And like, I think that's how much I judge by the time that goes by. I'm like, I haven't seen Mike in a long time because yeah, that shirt's looking really good on him. thanks for being here. I think you look incredible. Hopefully you share some secrets on the guns during the show as well.

Joe Gambino (01:07.635)
So our.

Michael (01:31.116)
Yeah, Well, I tried to squeeze this podcast in between sets of biceps, so I'm kind of a time crunch, but.

Joe LaVacca (01:40.734)
All right. We'll take a break every 90 seconds. If the show goes dead 90 seconds, everybody knows what's happening.

Michael (01:44.248)
I think you

Joe Gambino (01:44.575)
Hahaha.

Joe Gambino (01:48.991)
Joe, I mean might say the same for your quads though too so it's pretty fair. You gotta throw it in there.

Joe LaVacca (01:53.048)
That's, I appreciate you working the quads into the conversation, Joe. Yeah, that's the only thing I got going for me these days, Mike, is the quads, my posterior, my derriere is growing a little bit, but you know, just yeah, but I'm pretty happy with that. I'm pretty happy with that so far, but.

Michael (02:05.719)
Good.

Michael (02:10.584)
Just off the cuff though, are you now a little bit more amenable to like the style of shorts? You know, they're shorter, they're...

Joe LaVacca (02:18.296)
yes, of course. Yeah, yeah, yeah. I feel like I've worked so hard. You have to show it off a little bit, you know? So I was a big, you know, being from Staten Island, you know, I was a big jean shorts guy, you know, to the knee or below, you know? I was only showing shin half the time. Now, you know, it took a little bit for me to, yeah, of course. Yeah, obviously, you know, of course. But now the shorts have been riding up higher and higher.

Michael (02:24.63)
Yeah.

Michael (02:38.837)
Do you want to

Joe LaVacca (02:47.768)
I'm not quite at bathing suit speedo level just yet. I don't have that confidence, but who knows? By the time I turn 40, I'm thinking that I might be a speedo guy.

Michael (02:54.808)
Okay.

Michael (03:01.942)
Yeah. I mean, shoot for the stars, man. You got it.

Joe LaVacca (03:04.044)
You

Joe Gambino (03:04.223)
I am glad the jean shorts hasn't really made a comeback as far as style goes. So that's that's a plus for me The George's yeah, I have a buddy who who has this one pair of of George and they're extremely short and you bust him out every now and again, but he Unfortunately, well, maybe it's not unfortunately. It's probably fortunately doesn't fit into many more So but yeah, they're quite a quite a sight to see

Michael (03:13.24)
The Jorts?

Joe Gambino (03:31.743)
But our first question for you, Mike, because there is a very loose coffee theme to this podcast, which I think I was talking to Joe, where we might lean into a little bit more in the future. But first question is, how do you take your coffee? And this is Joe's learning experience here as people talk about their coffee on the show.

Michael (03:48.728)
I am a either a nitro guy, black, or some kind of cold brew with light ice, black. So, I'm going for the cappuccino.

Joe LaVacca (03:57.918)
Nothing hot. Nothing hot though.

Joe Gambino (03:58.87)
Simple.

Michael (04:02.688)
No, it's not hot. I don't drink hot coffee.

Joe LaVacca (04:04.0)
Okay, all right. And it doesn't change for you at all during the course of the year? We just like, is there a particular brand or store? Are you a Starbucks guy? Are you like a craft coffee guy?

Michael (04:16.226)
So I think Starbucks just at a sheer convenience because I do like it consistent. You know, and I know what I'm going to get from a nitro for the most part, but room temperature, round, black, no, in it suits me perfect.

Joe LaVacca (04:33.688)
Yeah, see, I appreciate this answer, Joe, because we've had a lot of people come on. They're like, I feel like they're shipping coffee from like Indonesia and like all these like different parts of the world. They're talking about where the bean was grown in the dirt, how they steam the milk. And I'm like, whoa, I don't have time for this. You I just need, you know, some black coffee. I have been dabbling more in milk, you know, changing it up with different types of milk. So it's one of the...

Joe Gambino (04:36.329)
Mm-hmm.

Joe LaVacca (04:59.05)
One of the coffee connoisseurs at the gym told me that's how the flavor profile of the bean really opens up when you add cream, especially to a light roast. So, I don't know, I've been dabbling. I've been dabbling.

Michael (05:10.86)
I think coffee is kind of in that same genre of like, you know, what craft beer was a couple of years ago where everyone was like, you got to these this and that. I'm like, give me up like a Paps blue ribbon because I'm drinking it to get drunk. Right. And I drink coffee for the caffeine. Like obviously I'd like it to taste good. but I don't like sugary. I don't like dessert for coffee. Now I'm not saying you're doing that. I'm just saying like coffee's coffee, beer's beer.

Joe Gambino (05:17.407)
Mm-hmm.

Joe Gambino (05:23.865)
Hahaha

Joe Gambino (05:36.721)
I'm just...

Joe LaVacca (05:36.856)
Okay. No, no, no. Hi. Yep.

Michael (05:41.098)
I don't need to know the hint of cranberry in my beer.

Joe Gambino (05:45.437)
Hahaha.

Joe LaVacca (05:48.728)
That is fair. That is fair. Yeah. Yeah. Are you okay with another personal question? Is there, yeah, is there something that you're reading, writing, watching that you're particularly enjoying right now? Or I should say writing. should say reading, listening to, or watching that you're particularly enjoying right

Joe Gambino (05:49.983)
appreciation for the simple things.

Michael (05:51.703)
Yep.

Michael (05:55.66)
Yeah, that's why I'm here.

Michael (06:12.354)
So I don't usually, I actually don't listen to a lot of podcasts. I don't spend a lot of time in the car where I, or a time where most people would be consuming podcasts. so I I'll have like a podcast that has been cut down, like 10 minute intervals where I have a moment to listen that I'm into. And it's usually going around business or, marketing or something that has like a deep root in like business ops.

right now because that's what I'm trying to get better at professionally. And all everything that I'm consuming from a reading list perspective is usually around like business ops, executive functions, like how to redefine, to like elevate yourself to bring other people up. Because I think that's usually the biggest constraint in small business. And if you don't address like that main constraint, then nothing else will grow or the growth will be very limited. So everything that I'm consuming right now is about like how do you actually

Elevate yourself, delegate better, and then elevate others.

Joe LaVacca (07:16.706)
I love that. And that kind of goes in line with a lot of the stuff that's going on at your gym and your clinic. Do you want to just share that with a little bit? Like what the clinic is doing now, how you guys have changed, what your focus is, and then we'll get into the big stuff.

Michael (07:30.648)
Yeah, of course. you know, I've been to my, my, my childhood friend who was a general surgeon a couple of years ago, he came to the facility and just needed kind of a, a reset. he, you know, understood that his, habits that he had wasn't carrying the life that he wanted. And that was around, you know, how he was taking care of himself, how he was showing up for his family nutritionally, lifestyle, fitness, all that stuff, kind of like.

You know, he just put on the back burner and he realized it was time to, kind of re prioritize some things. So long story short, had amazing transformation. He looks great. He feels great. And then when he was practicing medicine, he had this like existential crisis of like, I don't even feel like I'm doing the right service anymore. So we were brainstorming and this is probably about three and a half years ago. Like how can we operate together? So let's fast forward that. And now he has what we, we consider proactive.

a proactive healthcare service inside the gym. So we have all the diagnostics. have a, we have blood panels. have a DEXA scan. We have a WAVI. We have RMR. We have VO2. He's allowed to prescribe peptide therapy to hormone replacement therapy to customize vitamins. So everything that it like it's for the consumer who wants to empower themselves with healthy choices and not be caught up in. I'm not, I'm not trying to sound.

condescending is corporate health care. Like they don't want to be in that system. So, and there's not many alternatives that, you know, actually provide value or return for their time and energy. So we wanted to create that. And of course we are two different businesses legally, but the service structure is shared. Like there's rarely a time where he would be like, well, exercise isn't part of the prescription plan. You know, nutrition is part like.

Joe LaVacca (08:59.234)
Yeah.

Michael (09:23.788)
Just because you're getting your hormones doesn't mean you don't worry about sleep and stress management and exercise and cardiovascular fitness. You know, but he has a very good understanding because he went through it as an end user with us to say like, Hey, listen, this is what you need to like stick to so that you get the best ROI out of all these other therapies and interventions. So he has a very unique perspective as a medical doctor, understanding that the high value of

training, nutrition, lifestyle integration, things of that nature.

Joe LaVacca (09:58.752)
Yeah, that's really great. I think that kind of flows really well into like the big first question that we had for you, because something that me and Joe had talked about in the podcast previously was how many people come and see us. And they think that, you know, we don't struggle with the same things they do with pain, with, you know, making decisions with carving out time for family. So you mentioned that that's sort of the impetus of how your friend came to you.

Michael (10:18.679)
Yeah.

Joe LaVacca (10:28.308)
And it resulted in this wonderful transformation of maybe both of your businesses. So when you think about yourself, if you wouldn't mind sharing, was there a similar story for you? Have you struggled with pain or injury? And if so, how did you learn to cope with it, move beyond it?

Michael (10:49.43)
Yeah, I think I had this, know, like if you look back in your life and you try to think about like, what was the turning point? Good, bad or otherwise? And I always go back to my senior year in high school where I suffered an injury that was at the time, like life altering. More so because it displaced the sense I had of myself and the identity that I thought I was. And I ended up, let's say,

not going to the school I wanted, not fulfilling my dream of football and academics and all that stuff. And I really had, even though the, you know, for the most part, the scars healed, I really had a very poor relationship with myself because I felt like let myself down. Like I, like after that, that moment, I really could not divorce myself from the idea of failing. And at the time I was kind of like, you're all American, work hard, overachiever.

Nothing can stop me, blah, blah. And then all of sudden there was something I just couldn't outwork. And it was, was like, don't forget. mean, 18 year old guy, like doesn't really have a great perspective. So once you displace yourself from like something that is really tied to your identity, like sports and you become injured, like you lose a sense of yourself, or at least I did. And it was really hard for me to like regain that until years later.

where I just didn't have closure to it until I was probably in my mid-20s, in all honesty.

But I don't know if that answers.

Joe LaVacca (12:21.132)
What do you, yeah, no, it definitely did. What do you think helped you either regain your identity in your mid-20s or shift it to something else that you can hold onto and grow with?

Michael (12:35.522)
Well, part of it was like letting the notion of what my identity was founded on go. You know, so at the time it was like, you know, like all American kind of kid, you know, just work hard, do good stuff. know, your dreams will just materialize, right? And a lot of that was associated with football and playing sports and being a student athlete. And it really wasn't until I pursued something professionally, like strength and conditioning, where I was like, man, this is...

This is actually, really do love this. And I love the idea of getting in front of injuries. And I loved, because at the time, we're talking about almost 20 something years ago now, you know, like strength and conditioning was very much a, in its infancy in terms of the professional realm that it is now. So looking at it as a way of, you know, getting in front of injuries, helping people reach their potential, helping people cultivate the beliefs and the skills and the character traits.

like really resonated with me at the time. And it still does today, but just for very different reasons, because I was, I was using strength and conditioning to, self-improvement. And I found it was like, my God, I can help other people this way. at the, at the, you know, the crux of strength and conditioning is the ability to overcome. And that's like such a great metaphor for life. In my opinion, you know, the idea of strength and conditioning is, is that you meet something that, is

bigger, better, harder than when you're gonna see it again. And through these series of graded exposures, you become a different organism. And that doesn't mean that just physically, like there has to be a mental adaptation. There has to be a spiritual adaptation. There has to be a perspective shift. So the way that you can actually create your existence is tied to what you do. And therefore your identity can change, in my opinion.

Joe LaVacca (14:32.296)
100%. When you started this Shrinking, Additioning journey, we'll stick with that, for self, what was the kind of shift to realize that you could give back? Was there a mentor involved? A lot of people who are in persistent pain, one of the things I try to coach them on is sometimes that way out is giving back, know, like finding that identity again. So,

Michael (14:54.508)
Yeah, of course.

Joe LaVacca (14:57.624)
What was it about either your transformation that helped you realize, this is going to be important for other people. And, you know, if there was a mentor involved, that would be cool to hear.

Michael (15:08.984)
I mean, it was somewhat of a distraction, I think. And I think a lot of people that get into coaching, teaching, mentoring, they're met with these feelings of positivity because they're doing right for other people. And it's a way to obviate the pain or the need to address their own in the beginning. I think people can overcompensate in that way and become almost like a martyr like. So on one side, it's like, I will help the world.

despite me falling apart. You know, I think we all have, you know, whether caregivers that come to mind or teachers or coaches that just like they did great things for others and they couldn't just take care of themselves. Right. But I think at one point I just started feeling hypocritical that I wasn't actually living the lessons that I was trying to provide for others. And that really just took some self-reflections like, well, why aren't I healing? Right. Like, why aren't I doing these things? Why aren't I like really

allowing myself to grow at the same rate or the same way that I'm advising others. So there was a sense of like cognitive dissonance here where it's like, man, I probably need a coach. I probably need a mentor, you know, and that's where I felt as though, I mean, I have too many people to thank for this podcast, but there were many people along the way that were very helpful in me kind of realizing some of the things that I had to work on and then provided feedback.

on how I was doing. You know, we were talking offline before about like, there's nothing better than like putting all your effort into something. There really, don't think there's a better proxy for honesty. Like when you work your ass off, it better mean something to you, right? The only thing bad about that is if you're not working efficiently. And that's where mentoring comes in. Because then it just amplifies your efforts towards working towards the right thing and how you're working for that thing, right? So I think there was a lot of...

You know, a lot of credit needs to be provided to the people that were in my life at that time as mentors and, people I just gleaned information from. So.

Joe Gambino (17:18.623)
No, I like that a lot. I kind of, feel like when I was younger, I was just like, I don't know, you almost have that, like, you feel like you can overcome anything and you didn't need help and things like that. And I think if I would've just got feedback when I was younger, I wouldn't have had back pain for like 10 years before I was able to get them mostly solved and stuff like that. So I really liked that. But you, you know, outside of just the, you know, you felt like, mentally you're ready for change. What would you say was kind of like one of the

One or two things that like really helped you kind of get your, your body back or help you overcome the injury and what was the injury? don't even think you really mentioned it.

Michael (17:57.27)
I didn't mention it, I had, oddly enough, had compartment syndrome and it was misdiagnosed during a football game. And basically they said, you tore your calf in half. It was the first quarter of the biggest game of the, you know, like classic, you know, high school football, first quarter. long story short, I'm on the sideline. I'm, I'm in some significant pain and the trainer on site was like, well, you tore your calf in

He's like, well, I was like, well, can I go back in? And he's like, if you can take the pain, you can go back in. I was like, I'm going back in. So he taped it. He wrapped my calf in the first quarter. By the fourth quarter, I had barely any function of my foot and finished the game. We won by the way, by two points came off the field and you'd probably go. Yeah. I got the game ball somewhere here, but no, I'm serious. It's probably, it's probably my kid's room, but

Joe LaVacca (18:46.508)
Congratulations.

Michael (18:54.682)
he's like, you should probably go to the hospital. I'm like, why you told me the cap was torn. When am going to, what are they going to do? He was like, you're right. So he sent me home. So long story short, or short story long at this point, 36 hours later, I go back to the ER and I went multiple times and they all said the same thing. One doctor's like, you have to go to the ER right now. They check the pressure in the leg, the anterior compartment. If you don't know normal pressures are right. 25.

They do surgery at 35, mine was 140. So they sent me in and at the time they thought they were going to have to amputate my leg because it was already necrotic. And so for a week I was in the hospital with the leg just wide open because they couldn't sew it shut because of the swelling was so bad. I mean, it was like huge. and then they, you know, sealed it up and had nerve damage, had, you know, a lot, a lot of stuff.

Joe LaVacca (19:24.921)
my God.

Joe LaVacca (19:39.106)
Right.

Michael (19:50.508)
That was my senior year in high school.

Joe LaVacca (19:50.56)
Yeah, would have. Yeah, I mean, I appreciate the notion that you won. have the game ball because Joe shared a story last week that when he got tackled, he broke his wrist, but he didn't score the touchdown. And I was like, Joe, you know, why would you share that part of the story? You could have like made everyone like, you know, I dove as I broke my wrist. It shattered in four places, you know, and, know, his honesty took away from the story. I.

Joe Gambino (19:52.735)
Well.

Joe Gambino (19:57.847)
Yeah.

Joe Gambino (20:04.68)
Mm-hmm.

Joe Gambino (20:08.487)
Yeah.

Michael (20:11.159)
Disney.

Joe Gambino (20:13.683)
You

Joe LaVacca (20:18.422)
That's what I was hoping for. There was a success in there somewhere, but the idea of mismanagement is something that a lot of, think, patients and clients feel or have been subjected to. What do you think helped your trust come back in either the healthcare system or to start realizing, hey, I have to do better than what the healthcare system is offering, like you were saying before.

Michael (20:32.866)
Totally.

Joe Gambino (20:36.767)
Okay.

Michael (20:48.417)
Hmm.

Joe LaVacca (20:48.64)
It seemed like your friend and you were, he was sharing a lot of, wasn't doing the right thing. I wasn't doing the right thing. I wasn't showing up for my family. I wasn't doing the right thing for my patients. But given all your history with mismanagement, how did you come back to trusting the healthcare system again?

Michael (21:04.502)
Well, I don't think I really did. And to this day, like I think I have a better perspective of like what that actually means. But maybe the reality is that just like every other profession, there's good providers and bad providers and environmentally, like how things are set up. It's really hard to, even if you're a good provider, do what you want to do or do what's necessary. So I think part of my journey was finding people on the fringe or alternative ways.

You know, that's why I have an interest. I'm a massage therapist. you know, I've, I've always worked with chiropractors and physical therapists. There was always an element of what can we do to get in front of this so that we don't depend on, you know, like true healthcare, which is just like, they're playing defense. You know, they're on their heels operating like in a reflexive manner where I always want to take. And the kind of our tagline is aggressively healthy and the Latin root of aggressive means to move towards.

So how do we move towards the answer and hopefully minimize? Like there's always gonna be a need for hospitals and that, like I'm not trying to say that's not important. I'm saying it's set up not in a way to help people who wanna live this proactive preventative kind of style of life. you know, like I think, you know, easily when I met Charlie Weingraaf back like 15 years ago, like he was a guy that was already thinking about like rehab and training is the same thing. Like it's a spectrum, it's not a pioneer.

Joe Gambino (22:28.276)
Mm-hmm.

Michael (22:30.038)
And he had these frameworks that I really, I really gravitated towards. And before him, there were other people, because again, strength and condition was an emerging field and they were starting to be this blended approach. It wasn't really consolidated in the way that like Charlie presented it back in 2010. Right. So I was always looking for people and remember the, the internet and strength and conditioning on the web was like T nation and bodybuilding.com. So like resources were somewhat limited, but,

Joe Gambino (22:55.539)
Mm-hmm.

Michael (22:59.788)
but it was also really authentic. know, guys were just giving their best answers. know, like most of the people back then, like there weren't certs, there weren't like all these courses that you could take. They didn't have proprietary, you know, functional, like all these things that are now really prevalent didn't exist. So people were just like, hey, here are my thoughts. And they were very, they're very transparent about why they thought about it. And like, and they, like, you didn't have to buy shit to figure it out.

Joe Gambino (23:15.263)
.

Michael (23:28.28)
Like they would just give you an answer and be like, Hey, maybe you should try it. So you had, you had more conversation and dialogue rather than, know, here's the course I'm the educator. is what's, you know, absolutism.

Joe Gambino (23:29.977)
Mm-hmm.

Joe Gambino (23:37.663)
Okay.

Joe Gambino (23:41.727)
Yeah, that's funny. I always think about that because when I started personal training, it was 2007 and it was like just at the cusp of when the strength and conditioning started to like have a little bit of like an online presence like Mike Ronald and Cressy. You know, like there was a little bit more information than just I mean, I grew up on Teenation and Bodybuilding.com and all that stuff, too. But it's interesting. I have a couple of questions for you. don't know which way I want to kind of ask it.

Michael (23:57.752)
Yeah.

Joe Gambino (24:11.689)
I think I'm kind of go back to your story if you don't mind. I'm curious because I mean, that sounds, was a major injury, surgery, nerve damage, things like that. Does it still impact you to today?

Michael (24:15.98)
Yes.

Michael (24:27.064)
I mean, probably a little bit. I mean, there is permanent damage. They took out 12 % of my calf. know, like more so unless it hurts that day, I don't even know it's You know?

Joe Gambino (24:30.004)
Yeah.

Joe Gambino (24:40.831)
Okay, I guess my question or where I'm coming from is, there's a lot of people with injuries and they feel like they need to either be like 100 % pain free. You know, they have a hard time navigating when there's still like some things going on. So I was wondering where you are from like a mental standpoint or how you navigate that if it's still lingering around to this day.

Michael (25:00.502)
I mean, I guess so mentally I look back at whatever five, seven years that I actually needed to heal. And I think about it fondly. Like that was, that was my thing. That was the thing that like, like, listen, no one gets out of life unscathed, you know, and, and you start to look at people, whether there's like, I rather use the word trauma than injury, because we know trauma could mean multiple things from multiple, multiple different pathways.

And usually there's two sets of people and I don't mean to categorize, but just for the ease of the conversation, there's, people that talk about like what happened to them, right? Like I got hurt and it fucked up my life. I could easily say that. And I did say that for the first seven years. And now I look back and I say, look what I was able to do from that. Look what I made from it. You know what I mean? So like, I think there's also a sense of, you know, what vantage point it's the same thing.

I got hurt, I got injured, I got screwed over from, like, whatever. But what happened? Like, that's the difference between the stimulus, the trauma, the response, and then ultimately the outcome of the scenario. And we get to control that, which I think is something that feels way better in retrospect than in the moment, because we have to go through the pain, we have to go through the struggle, we have to go through the hurt.

But it's how we're going to actually, and maybe it's just a form of alchemy where we get to decide what we transition it into. And that's why I've been able to kind of leverage in my old age now. Yeah. Yeah, right.

Joe LaVacca (26:37.3)
Older age, Mike, we don't say old around here. I think it's amazing how, I've always said this, how the universe is sort of connected and people come into your life at the right times or you read things at the right times. And I just got done reading Man's Search for Meaning. it was one of the greatest books I've ever read. so much of what you just said reminded me of that book, the stimulus, the space between...

Michael (26:52.44)
Fantastic.

Joe LaVacca (27:02.614)
what happened and the response afterwards, right? Like acknowledging that space, growing that space. And then even from a mental health standpoint, know, who you are versus where you see you're going. Like that bridge right there is like really the mental health aspect for so many people. And I think you touched on it and I love and I appreciate, and I hope people hear how you were able to reframe that healing time by looking back on it fondly and then restore

sort of this whole picture of mental health and identity by saying, hey, yeah, this happened to me, but now look what I did from it versus, hey, this happened to me and look what it took away from me. Because that could just as easily be your story, right? And I think from one of the questions that I had, maybe this fits in at a good time now, that's really difficult for people, right? We're not good at behavior change.

Michael (27:43.864)
Probably.

Joe LaVacca (27:57.314)
We're not good at restoring narratives in our life, right? At least not with lot of effort and practice. So when people come to see you or your clinic or your friend, how are you guys identifying when people are ready to really make that change? Because I think a lot of people maybe pay lip service to it, but do you have things that you specifically look out for with people who are willing to commit?

Michael (28:15.148)
Hmm.

Michael (28:22.54)
Well, I think I can read people pretty well. and I think, you know, like when you, when you talk about motivation, which is this kind of this weird term that every, means something different to everyone, but we'll use it in the general context of like motivation is basically your probability to do it. Right. Like you can only tell if someone's motivated if they do the thing. That's the only way that you can tell if someone's actually motivated, right? Like they did it or not. You were unmotivated. So you didn't do it. You motivated whatever.

So when I'm talking to a client and I have a good feeling, one of the lines of questioning that I have is, what's going to keep you from getting what you want? Constraints, right? I'm a big believer in like, you know, dynamic system theory, like we're dynamic, we're, you know, we're, we're, we're pretty eclectic in like what our environment looks like and how we perceive things. But I want to know what's going to get in your way. And I found that the more times people point.

to things outside of their control, the less likely they are to be successful unless I change that variable. And I forgot who said it, but basically wherever you point the finger of blame, there goes the power, right? So if I blame my schedule, right? How many times have you said, just, I mean, my, I can't fit that in. I don't have the time. I don't have the money or, you know, now that I'm more of the parenting age, people say,

it must be nice owning a gym because you can go there anytime I got, you know, my kids, you know, it's like, you should be careful with how you blame your, you're blaming your kids for your lack of fitness. That's what you're, what you're saying. You know, like you don't mean it, but that's what you're saying. So the more times people to point to external things in their life, the less control they will actually have over their life. But if someone says.

Man, I just got to snap out of it. I got to take responsibility for my wellbeing. I got to take some accountability. I need some help. And they start pointing the finger at them. I know they are willing to then absorb the responsibility and therefore reclaim the power of dictating the rest of their life. And then it's just basically logistics. like, all right, let's set your schedule up. Let's get your food right. Let's, you know, all these other things that become more practical considerations are way easier to remove.

Michael (30:43.404)
than someone saying, I don't have the time, it's not the right season, know, the stars are not aligned, pick your poison here. But the farther away that they point the finger, the less control they are of their life.

Joe LaVacca (30:57.024)
I think my favorite is when Mercury's in retrograde. You know, that's why everything is, you know.

Joe Gambino (31:00.103)
You

Michael (31:00.754)
It's a scary time for us all.

Joe Gambino (31:04.461)
Hehehehehe

When you do have people who are kind of talking about time, their schedule, whatever it is, and they are working with you, how do you try to pull them to either pointing the finger a little bit more towards themselves or make the shift to make the changes that they need to at least start the process of getting to where they want to go?

Michael (31:32.12)
I mean, it's all situational, but I try to ask questions that allow them to arrive to the answer that we both agree on. Like, I know it's not like you're watching television. You're on TikTok. It's not that your schedule is that hard most of the time. Right. But for me to say that to them, as opposed to tell me where does your time in the day go? And then, then they start to be like, well, you know, I, you know, I dropped the kids off and then I do. like, well, then what do do?

Joe Gambino (31:51.614)
Hmm.

Michael (32:02.134)
Well, I watch Sports Center, of course, and it's like, okay, so that's an hour right there. You know what I mean? So we can, we can start to figure out what are the access points of us really creating something because we know in exercise, something is better than nothing without a doubt. So I don't care if it's a 30 minute walk. I don't care if it's a 45 minute aerobics class. I don't care. I don't care, but it's got to be something that is positive that you perceive valuable.

that you're willing to commit to so that you start moving forward. And if it's two times a week, awesome, that's better than zero times a week. And I think most people would agree to those statements. So rather than me telling them, I ask them questions so that they can get to the point and be like, because if they come up with the answer, then they're also kind of admitting that they can do it. Rather than me saying, all right, don't watch Sports Center and come in the gym at eight o'clock. No.

Like most people don't like to be told what to do.

Joe LaVacca (33:03.658)
Yeah, that's a

Michael (33:03.66)
So I want them to be on the same side of the table. you know, like if we're in a room, like I don't want to be talking at you. I don't want to be telling you. I want to be helping you. I want to be part of the decision matrix with you on my side. So that's why I ask a lot more questions than just spout out answers.

Joe LaVacca (33:21.504)
Yeah, I think the, parenting thing that you brought up, I think is actually really helpful because I have these types of conversations with Avery, my 10 year old all the time. And one just happened this morning. And I said, what's going on in school today, other than, know, your math test. And last night we sat down, we studied for her math test and she felt pretty good about it. Right. And she goes, I have my standard for a music class. So she plays the French horn. Now, I don't know if you've ever seen a French horn, but it is gigantic.

Right? So last year when she was playing the saxophone, you she'd bring that, you know, to my house, to her mom's house, to and from school is, you know, sit in this nice little compartment. She can't bring the French horn everywhere because it's just too big. But she does have an extra one at her mom's house at the school that I already have. I said, well, you know, you don't have one here. So how's that going? I haven't actually heard you play. And she was like, you know, it's okay. you know,

Michael (34:08.888)
Hmm.

Joe LaVacca (34:18.2)
I didn't do as much for my French horn. And I'm like, well, what'd you do yesterday when you got home from school before I picked you up? She's like, I watched a zookeeper. And I'm like, well, could you, do you think that maybe there was a good time there to play your French horn? If you were a little worried about your stuff today. And she was like, yeah, I know, but I was just so tired. you know, and I was like, okay. I was like, well, do you think like your mind is like a muscle? Like, you know how daddy works out and you see me do this and you know what?

Michael (34:36.802)
Yeah.

Joe LaVacca (34:45.922)
I don't want to work out, but I know it's kind of good for me. And do you think that maybe if you would have just given yourself a little bit of time with that sax, then you would have gotten to watch the movie and done both and still seen both. And she was like, yeah, probably. But again, it was just that environment, right? Like there was no one around there to just give her that cue. So I think that's really important. So that brings me to this idea of, when you let people leave and

You know, you're on the same page and it seems like, hey, you guys sit down and you agree to something, maybe you sign a contract. How are you maintaining accountability with clients between sessions when they see you?

Michael (35:28.556)
So we have a pretty robust accountability system that we use at the gym and online. so we have a platform that like basically checks you in and informs the coach. If you have done the workout that was supposed to be done today. So you have to check it off, but you also have to fill in like weights, use exercises, done any notes. You also have different like lifestyle check-ins like sleep, stress level, water.

Body weight, we're, if we care about body weight, there's also a nutrition piece. So there's a lot of different ways that we can, we can point to like, are they on the right path? And there's going to be a point where you're, deviate. Like we know that for whatever reason, your kid's sick, you got a wedding, you got crazy work, whatever. But the point is not that you deviate, it's that you know where to get back to. So we can, if we can compress the limbo period of a deviation to writing the ship.

We know you're in a better spot as well as feeling like you're never on an island by yourself figuring out what to do next. And again, that's the importance of oversight and feedback and someone on the other line, you have a lifeline to a coach. So every coach in my facility has a roster of their own. they might be, there might be 300 members, but every coach has their own roster and they are literally their accountability coach. I say this all the time. We don't sell training and nutrition. We sell accountability.

Like we do that. And I think that's why we have really a high success rate, both on the individual level at the business level, we have a very low churn rate. So we don't lose people because I don't think people like there's no lost sheep. And if we're just not the right provider and they signed up because they thought they could do it, what, like we let them go, you know, so like we are very much in tune with like the shit that life throws at you.

And we're not gonna judge you, but we just wanted to get you back on the path. And if you know what the path looks like and it feels like, and you know what's expected of you, you're much more likely to do it. So.

Joe LaVacca (37:31.742)
I love that. oftentimes with the accountability, I use True Coach, which is sort of like this, like the same idea, right? Yeah. So like you can create these little habit boxes and stuff. And I think what I always tell people is that value of, you're not paying for an app, right? You're paying for interaction, for coaching, to ask questions. And yeah. And I think the most common question I get

Michael (37:38.934)
Yes, same.

Michael (37:52.12)
engagement.

Joe LaVacca (37:56.152)
is, hey, I'm having a little bit of pain today. Like, should I do my workout? Should I do my soul cycle class? And then after like two or three questions, we deduce it down to, yeah, you're probably pretty safe. Why don't you go for it? And I love getting these messages back. Like, hey, you were right. I went in and I did the class. I'm so happy that I did it because I wouldn't have done that. So I think that that accountability piece is so, so important. Is there...

Then in that same regard, when you're looking at behavior change, do you have a cutoff for if something's not working for someone? I've read, you know, the first two weeks are the most important, for instance, or the first 30 days are most important. Do you have to have difficult conversations with people where, Hey, I know you really want to do this, but now it might not be the best time. And maybe you just leave them with, you know, focus on this one thing instead. And I'm sure that's very individual, but maybe we could speak in generalities. Like if you have had to have that conversation.

Michael (38:45.334)
Hmm. Sure.

Joe LaVacca (38:51.798)
What is the most common thing you leave people with to just focus on if they're really having a hard time with that commitment and accountability?

Michael (38:58.808)
So, before we even get going and we're kind of agreeing to terms like, hey, you're going to work with us. This is our expectations. Here's your expectations of us. We agree to that. And this is something that I just hate about this saying that permeates the fitness industry is trusting the process. I don't believe that. me personally, I don't believe that because that means that there's like blind faith involved.

And that's not good for the provider. It's not good for the end user. So what I rather get in the habit of saying to people is engage the process. Just do it. Just do some stuff. me, let me help me help you kind of thing. Like let me coach you, fill out your sheets, show up three times a week or whatever we say is going to be the thing. Hit your 9,000 steps a day. Hit your hundred ounces of water and just do that check in and let me see what I can do for you. Right? So if they don't do any, if there's three weeks that go by.

and they haven't done anything to your point, there needs to be a hard conversation only because you have to tell the truth. And sometimes that's not fun, right? But I'd rather be honest than just polite.

Right. I just like, I don't want to waste your time. I don't want to waste your money. Like I value people's time so much. I value their attention. Like if this is making your life worse, then maybe, maybe you should just go to a commercial gym and walk on the treadmill. Don't spend the money. Right. And I, like that, I have had that conversation and most people respond very well, whether they stay or not. And like, I think this is part of like, when we're talking about a consult or a sales opportunity.

The point isn't to get them to buy. The point is to get them to decide so that they can commit fully to that decision. And if that means no to us and yes to somewhere else, God bless, right? And that can happen at month one, day one, year 10. Like if I'm not doing it and it's not working for you, let's figure out why. If we can't remedy that, then I thank you for your time and your attention.

Joe LaVacca (41:06.189)
I think it speaks to your whole story, Mike, of being genuinely interested in the betterment of the person in front of you. And I think that's probably why people gravitate towards it. And those difficult conversations, especially around people with pain, it's that fear or worry about making things worse. So I love that engage the process because so many people are stuck.

when they come see me and Joe, and I'm sure you especially as well, and it's just that fear of the unknown. So you have to prove it like one by one that you can do this. Now without, you know, sacrificing time with family or friends and especially looking at your schedule and if you've...

Michael (41:40.653)
Yeah.

Joe LaVacca (41:58.998)
follow you on Instagram or social media. You know, I hope everyone does after the show. You've dialed in this schedule where it seems like you can focus on one thing at a time, you know, and whether that's waking up early, being a dad, being a husband, being a teammate, being a coach, being a business partner. How do you recommend going about that for people in terms of identity as you started off our conversation?

Michael (42:03.17)
GEN

Michael (42:26.616)
Thanks.

Joe LaVacca (42:27.992)
Do you have them pick what is the most important identity and then build from there? Yeah, I'll let you just kind of run with that idea.

Michael (42:37.858)
So I look at a lot of the things that we were talking about from a lifestyle standpoint, people are unconsciously incompetent with some of these things. And it's amazing, especially in the health realm, whether that's physical therapy or nutrition or whatever, they just don't know what to do. And typically, when you look at your kids, when they don't know what to do, they don't do anything, right? Like you watch a kid who's playing a sport and doesn't know what to do, like they just stand there. And you see that with like health aspects.

When I don't know what to eat, I just do what I've always done knowing that it's probably not the best thing that I just don't know what to do. And all the information out there is conflicting and confusing. And I, and what if I do the wrong thing? So I think if we just looked at some of these things as skills, like you don't expect, I don't know if you guys play musical instruments, but if you've ever played a musical instrument, you absolutely suck the first time you play. But a really cool thing happens after about.

10 lessons or 10 hours or, know, like you can play three blind mice without looking at the sheet. You know what I mean? Well, you start to get better, but we feel as though that these things should be like innate abilities. Like nutrition is fucking tough. Ask for help and learn, you know, physical fitness is tough. Ask for help. Learn. And if we looked at it as a skill acquisition rather than just something you're born with or not, it again gets you back to empowerment.

through engaging a process. So just like we're talking about, time management might be the best life skill ever. And I've never seen it taught at middle school, high school, college, or any other school. They don't talk about it. And it's like, this is what we're talking about when you want to do it all and you don't know where to start. Record your time. The easiest hack, life hack ever, just in 15 to 30 minute intervals for one week.

Just write down what you're doing the moment you wake up to the moment you go to bed and understand where your time goes. And this sounds awfully familiar with someone who's never had any nutrition guidance and they don't know why they're overweight and unhealthy. It's like, do me a favor, write down, do a diet journal, right? And then people start to look at it. It's like, holy shit, I'm spending five hours a day. Go on your cell phone and open up how much time you're on your phone. It's actually frightening.

Michael (45:00.62)
And then see where that time went two hours on Instagram, one hour on ESPN. Like, you know, it's like, holy shit, I have all this time. And then, and then you can decide if you want to do something different with it. But it's this we're stuck in this unconscious incompetence. We just don't know we're bad. So therefore we can't get better at it. Right. And I think, especially when it comes to nutrition, we're, not only uneducated nutrition, we're, we're just unaware of the consumption and like how it's not getting us to where we want to be.

So if we look at this time component, that's part of the problem too. We don't know, we don't manage our time. Therefore, whether we have to eat fast food or convenient foods that might not be healthy. it just like trickles into one another.

Joe LaVacca (45:45.301)
Yeah, I think that's really great. I love that recording your time. I'll do that when I'm ready for it. I don't know if I can handle the truth,

Joe Gambino (45:53.545)
Hehehe. Hehehe.

Michael (45:56.896)
But that's exactly what we're talking about. We've got to be ready for this change. Right? But there's nothing that is probably more helpful than just like if you're someone who says, I don't know where my money goes. What should you say to that person? Maybe you should look at your bank statements. Like what did you spend money on? Like, you know, it is we've had some of this application in other parts of our life. We just haven't decided to do it with.

Joe LaVacca (46:02.424)
Yeah, right, exactly, exactly.

Joe Gambino (46:15.881)
Mm-hmm.

Michael (46:25.688)
time or food or whatever money, you know, all these big things, but you look at the big problems that most Americans face is like they don't have enough time. They don't have enough money. They don't have enough health, you know, like it's like, all right, well, let's let's start creating awareness around it. I don't care how you do it, but you got to get there. Otherwise, you're going to you're not going to make an informed decision. That's it. If a decision is predicated off the quality of information and you have no information,

Joe Gambino (46:42.793)
Mm-hmm.

Michael (46:55.03)
You are literally guessing, literally, not even my opinion. You know what I mean? So like when you have this sticking point in your life that's particular to some part of your life, record it, evaluate it, assess it, have someone else look at it, you know, and then make an informed decision about how you want to move forward. And if it is to change nothing, good for you. It's a free country.

Joe LaVacca (47:18.264)
Yeah.

Joe Gambino (47:19.231)
I love that. I find myself more and more like the conversation is always just driven around these same themes. It's like, well, can we track this? Can we start with something small? Doesn't need to be this huge major. Like everyone needs it to be perfect. Like let's get perfect off the board. You're not doing anything back to what you said earlier, right? Like something is better than nothing. So how do we start to create those pathways back in?

But yeah, I think this was this is awesome Mike Thank you for coming on the show. Thank you for sharing all this I mean, I think this also, you know, I think I may start to record some things on my time you know, I've been a Struggling a little bit with not necessarily. I mean lunch around lunchtime. I get really distracted and skipping some meals so that I've been working on that So I'm actually back to logging some food. So

I think this has been great. I wanted to give you the floor just to let listeners know where they could find you, where they can learn more from you, anything like that.

Michael (48:24.248)
thank you. I mean, I, I'm somewhat active on social media, Instagram being probably the, favorite platform or at least most used platform at this time. So, you know, Michael ran phone is, is me ran phone training is the gym. it's a lot of shared content. but we put a lot of stuff out, like a lot of information stuff about, you know, how we think about, you know, training, how we think about health, how we think about practicing medicine in an integrative fashion. So it is like.

The two businesses kind of just sharing best practices and thoughts. So if you're interested in that kind of stuff, definitely, you know, take a listen. We do a podcast that's called not sure this matters. We just put that on Instagram. I think not, not sure this matters podcast. and that's, that's, you know, it's very, I think it's pretty entertaining, but there is some educational pieces to it. but we have a moderator that is not in the space and not in the industry who asked.

fantastic questions and he's pretty funny too. And he's, he's got a real knack for making whatever we're saying, you know, easily consumed, and digestible. So, again, just more information that we're trying to get out. And, those are probably the two best places I'm on Facebook, but honestly, I, Facebook is like a cesspool to me. can't, I'm there. So, but if you have a question, I mean, I try to respond to as many EMS possible and, I'm pretty approachable.

Joe Gambino (49:43.955)
You

Joe Gambino (49:54.739)
Awesome, man, I can attest to that. So again, man, thank you. I'll get all that stuff in the show notes so anyone who wants to follow Mike or listen to the podcast, all that stuff will be easily accessible to you. And Joey Boy, take us home.

Joe LaVacca (50:10.376)
All right, well to everyone who's made it this far, we love you. Joe, Mike, love you guys. Thank you so much for your time and please come back next week for another exciting episode of The Beyond Pain.