The Beyond Pain Podcast

Episode 36: Our Top 5 Takeaways from 2024

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Summary
In this episode of the Beyond Pain podcast, hosts Joe Gambino and Joe LaVa discuss their experiences with fitness, patient care, and the importance of communication in healthcare. They share personal stories, workout routines, and insights gained from their podcasting journey, emphasizing the significance of trust and connection in patient relationships. The conversation also highlights the resilience of individuals dealing with pain and the value of sharing experiences to foster understanding and support. In this conversation, Joe LaVa and Joe Gambino explore the themes of behavior change, motivation, and pain management. They discuss the importance of taking action to create lasting change, the role of motivation in the process, and how pain can be perceived and managed as a skill. The conversation emphasizes the need for consistency and patience in achieving personal growth and health goals, while also reflecting on the emotional aspects of dealing with pain and setbacks.

Takeaways
The importance of communication in patient care.

Sharing personal stories can help patients feel less alone.

Trust is crucial in the healthcare provider-patient relationship.

Action often precedes motivation in achieving fitness goals.

Podcasting has enhanced our understanding of patient experiences.

Workout routines can be both challenging and rewarding.

Listening to others' pain stories can inspire resilience.

Building connections with clients improves outcomes.

Creativity in fitness can lead to better engagement.

The journey of podcasting has been a valuable learning experience. We're in the business of helping people change behavior.

Action comes before motivation.

Many people wait for motivation instead of creating a plan.
Consistency takes 30, 60, 90 plus days.

Pain is a skill that can be managed.

You can shift your perception about your pain.

Feeling what you're supposed to feel is important.

Let your body process emotions related to pain.

This is how I know you can learn from experiences.

It's essential to have realistic expectations about pain management.

Joe Gambino (00:00.943)
Welcome back into the Beyond Pain podcast. I am one of your hosts, Joe Gambino, and I am here with Mr. Backwards Hat, squeezing workout this morning, Joe Lavaca. Welcome back in, Joey Boy.

Joe LaVa (00:13.864)
I'm happy to be here. You used the backwards hat one before, but you kind of saved it with sandwich again, the workout characteristic. And I do, I do want to sing you my workout today because yeah, when you're done with the intro, when you're done, when you're done with the intro, want to, cause that's why I was able to squeeze it in.

Joe Gambino (00:16.931)
Yeah. That's it. That's it.

You yeah, I'll allow it to happen. Allow it to happen. We may lose one of our 17 YouTube subscribers, but but we'll allow it.

Joe LaVa (00:34.542)
Hey, 400 % increase in YouTube. And we don't, Margaret, we don't really do anything with YouTube. I mean, it's just there for your viewing pleasure, but we don't really push it too, too much. So, you know, I think maybe we make a little push. Yeah. Exactly.

Joe Gambino (00:46.747)
Well, if anyone wants to watch us sing today, you know where to find Joe. Yes, well, as we mentioned, the show is on YouTube, cupsofjoe underscore PT. We would love Joe's looking for a 400 % increase. So I think our goal is 68 by the end of 2025. So get in there and shoot us a subscribe. And also on Instagram, I am at joegamebeato.dpt and Lavock is at strength and motion underscore PT.

If you are interested in working with us, there's an application form in the show notes and you can always reach out to us on Instagram to have a conversation. All right, Joe, tell us about your workout and sing us a Mary's song.

Joe LaVa (01:25.454)
So I guess, the first thing I would ask you or maybe have listeners reflect on, have you, you're all set for Christmas. Do you have anything to do on your list? People are shopped for, you got wrapped presents, all this stuff.

Joe Gambino (01:39.735)
Almost there's probably a couple of things I need to pick up still. And, then it's just having a handle dinner on Christmas day.

Joe LaVa (01:47.694)
Okay, that's really nice. Because I leave for Pittsburgh on Sunday as I was talking to you. I will be with Courtney and her family this year. And I think between now and Sunday, because we film on Friday morning, I have about 47 things to still do. My washing machine decided to run through its lifespan about two weeks ago. So I have to find my way to a laundromat. I feel like I'm back in college over the last couple of weeks. So I have to do that.

I have to ship out little strength and motion beanies. Yeah, check these out for people watching on YouTube. This is a little gift to, you know, people who've been training throughout the year, just as like a little thank you. So I'm shooting that out. Yes, yes, yes, I have one on reserve for you. But I have to do that before the post office closes so people get it in time.

Joe Gambino (02:22.267)
Joe Gambino (02:31.823)
Do you waiting for mine to arrive in the mail?

Joe LaVa (02:44.27)
I'm having my parents for our Christmas on Saturday. So I have to do all that. Right. So there's just so many things. I still have to buy like, I think one or two presents for someone also, mainly my mom, who I'm going to be seeing in about 24 hours from now. Right. So all this jammed in, I'm looking at my schedule today. I got us, I got meetings, I got virtual consults. I got to go pick up Avery from school. I'm like, when the hell am I going to work out? And then I opened up my TrueCoach app and I saw this workout and I was like, I think I could do it.

I'm gonna sing it to you though, cause it's the 12 days of Christmas. All right? So you do the workout like the song from the beginning. I'm gonna spare us that though. I'm just gonna go from the very, very end. So my workout today, 12 squat jumps, 11 pushup renegade rows, 10 single arm kettlebell snatches, nine VE ups, eight kettlebell swings, seven hanging leg raises, six burpees.

Joe Gambino (03:17.349)
Mm-hmm, go for it.

Joe LaVa (03:41.55)
Five double dumbbell push press. Four double dumbbell front rack lunges. Three straight chin pull ups. Two dumbbell thrusters. And one double dumbbell devil's press. That's it. So I started from the beginning all the way through. How long do you think that took me? To go from like one to two, back to one, back to three, back

Joe Gambino (03:48.218)
Ha

Joe Gambino (03:55.503)
This sounds fun.

Joe Gambino (04:02.971)
Mmmmm

That's a great question. I'm just gonna ballpark it. gonna say... I'm gonna just go right in the middle of my two numbers and say 40 minutes.

Joe LaVa (04:18.062)
40 minutes, 33 minutes and 14 seconds.

Joe Gambino (04:20.507)
I was between 35 and 45, so I just went right to the middle.

Joe LaVa (04:24.354)
I hear you, hear you. So I don't know if that's good or not. know, shot it off, but I was panting. And that's why I was a couple minutes late. And that's why I put the hat on because I quickly showered. I wanted to look presentable for you. But I also didn't want to be too late. I wanted to respect your time. So here I am. We're ready to rock.

Joe Gambino (04:32.325)
Yeah.

Joe Gambino (04:43.487)
That's all right. That's all right. We're ready to rock. You know, I do love just on a little side tangent note here. I love workouts like that. And I love when they're set, you know, I mean, like this is this is like a one and done. You don't don't repeat it.

Yeah, I like having little density like circuits like that. And that actually like extends because it's always surprising how much time people can shave off of those things with just like doing it from a work capacity standpoint. Have you ever heard of the 10,000 Swing Challenge by Dan John?

Joe LaVa (05:19.926)
I have. That's like 10,000 swings in a month, right? that, yeah, okay.

Joe Gambino (05:22.667)
Yes. Yeah. Yeah, it is. I will. I will never, ever, ever, ever do it again. I got the car key that used to go to my wife. I put the jingles in the background for the podcast. I will. Yeah, Christmas spirit goes to Christmas past. Come and visit me.

Joe LaVa (05:40.482)
I was like, what is going on? We got a little background music going on today. This is great.

Joe Gambino (05:49.371)
Yeah, I I did the 10,000 Swing Challenge with a while back. I think I did it with Frank Duffy and it was the most miserable experience of my life. you you go through this like, I don't even remember. I don't remember how many swings it is in the day. It might be like 250 or something like that.

Joe LaVa (06:03.502)
I was just, I was just 333 swings per day.

Joe Gambino (06:08.441)
Yeah. So you did that. I think I did. I think I did the four day cycle and not the five day cycle. I forget which one I did. But I think at the beginning it took me like, cause you would Paris like swings and then you pair it with like a movement for the, for that day. Yeah. Yeah. It's swings plus like one strength movement and each day had like a different, it was like a different category. So I had like pistols on one day with it. had some sort of press with it.

Joe LaVa (06:25.908)
And a movement? Good lord.

Joe Gambino (06:37.339)
I don't remember. It was so long ago that I did it. Anyway, it took me like 45 minutes, I think, to get through a day in the beginning. And by the end of it, I was doing it in like 28 or 30 minutes. So much time got shaved off. And shortly after that, I PR'd. It was the heaviest deadlift I've ever done. did like 355. Yeah, it was like a 25-pound jump. Yes, I did it with 53.

Joe LaVa (06:49.378)
Wow.

Joe LaVa (06:58.658)
That's awesome. Was it with a specific weight or?

Joe LaVa (07:08.194)
Okay, all right, that's very cool. That's very cool. And that was, was that the standard?

Joe Gambino (07:09.093)
Fit through

That was the, yes. Yeah, it was like 53 for men, 35 for women. Yes. Yeah. But that's what I saying. like those kinds of things. it's, you know, I'd like to do like density circuits for people where it's like, just like the workouts built in, each A block, B block, C block is like a time circuit. And the goal is to just do either more weight or more sets, throughout it. And then like, people are always like blown away with like how much more they can do. So little things like that, I think are always good because

Joe LaVa (07:15.36)
standard. Okay, very good, very good. Joe, I'm very impressed. mean, so

Joe LaVa (07:31.703)
Yeah.

Joe Gambino (07:41.531)
Going back to our episode where we talked about the 5-3-1 stuff is similar in that regard. Instead of maximal strength, we're looking at strength over a period of time. So it's interesting. I like stuff like that.

Joe LaVa (07:45.837)
Yeah.

Joe LaVa (07:52.396)
Yeah, that's really cool. I, I commonly would do that for like day four of a workout for people, right? You know, just to get a little bit more volume. And I think we spoke last week when we were discussing like what to do with missed days. And you mentioned that, you know, the beginning of your weeks very much like mine are a little bit more intensity based, a little heavier with weight. And then it kind of trickles down as the week progresses. But every now and then even with like the two day people.

I'll copy that four day workout in there and throw it on their second day. And they're like, what's going on? They're like, we were not prepared for this. You're trying to sabotage us. And I'm like, no, I just want to make sure you mix it up a little bit with some heart rates up, especially if you're not getting a lot of cardio in during the week. You got your two days of strength dialed in, but now let's just throw you something, a little challenge, if you will. So it's always fun to read their feedback when...

Joe Gambino (08:49.499)
That's awesome.

Joe LaVa (08:50.318)
You know, you got a little density day going against you there. So very good, man. All right. Well, three hundred and thirty three swings a day for 30 days. You might inspire some people for the new year. You know, this is a big.

Joe Gambino (08:59.099)
Yeah. I, you know, it's one of those things that I recommend, but don't recommend. It's like, you know, do it once, you know, test your body, you know, see how it goes. mean, I had to actually get like hand wraps at some point because, you ever, you ever play, don't know if anyone on this podcast that listens to it, we'll, understand the reference, but Mario party back in the day, we had to like the joystick, you had to rotate. You ever play the old school Mario parties? my God, Joe, you're not even gonna get it. You used to.

Joe LaVa (09:24.14)
No, I don't think so,

Joe Gambino (09:27.739)
If you played it a whole bunch because you there's like the like the center joystick and one of the moves you had to like, like turn it real fast. You'd get like little like the skin would just peel off and add that to like a really high extent after my swings. so I had to, I had to bandage that bad boy up to survive the month. But anyway, let's, let's switch gears. Let's get into the topic of today. We're, we're doing our five takeaways from, from 2024, our six months or so of podcasting.

Joe LaVa (09:32.43)
I remember.

Joe LaVa (09:41.776)
I love it.

Joe Gambino (09:57.701)
We'll kind of just alternate these and, know, spit ball and talk about them and what we learned. And, you know, I mean, I definitely enjoyed getting back into the podcast experience and, you know, learn from others and learn from you, Joy Boy. so let's, let's do it. And you can take number one.

Joe LaVa (10:15.822)
Yeah, I think I agree with you. I, this is the first experience. I think you did. Yeah. I mean, but I think this was the first experience I've had with a podcast. I had thought about doing one on my own and it never really appealed to me to just, you know, sit there talking to myself. and we had been talking about doing it for so long. I didn't know how long it would last, if it would last. And here we are episode 37 on our way to 50 and beyond.

Joe Gambino (10:18.607)
which I think I just segued into.

Joe LaVa (10:44.578)
So this has been really fun. So again, thank you for such a great year so far. I'm looking forward to the future. And that is my number one takeaway from the podcast over the last, I guess, six months, five or six months, is being able to sit down and chat with a clinician like yourself and maybe even our guests. But I'm gonna single you out here because we spend the most time together. And it's just been nice to hear your stories with Patient Care.

Joe Gambino (10:48.571)
You're welcome. Thank you, Joe.

Joe LaVa (11:14.304)
It's been great to hear your training advice with all your training background and being able to, you you brought up the five free one idea. That's going to be something I roll in with people in the beginning of the new year. And, know, just those little things of programming, how you structure the advice you give. I thought those were the best for me. So that's going to be my number one, working by yourself.

Joe Gambino (11:33.209)
Yeah.

Joe Gambino (11:41.797)
Eh.

Joe LaVa (11:43.156)
And I'm sure you can relate to this to some degree. You almost start living in a vacuum. know, your ideas make sense. Like you read and interpret your own thoughts and, you know, then you start to implement them with clients and we can always say everything worked or it worked, you know, better than what I was doing before. So I think I just appreciated hearing a lot of the alternate ways of thinking, alternate ways of training.

So there's number one for me and I hope that the listeners got something out of that as well listening to us, know, trade ideas not only as clinicians but as people.

Joe Gambino (12:24.091)
Yeah. And, you know, it brings me back to like our perfect strides. I mean, working in, you know, solo in your own business, you don't have anyone to spitball with or do things. I mean, that was like what like the one thing I loved about being a perfect try with like you and Pekash and Dan is like, he's going to walk over. And I mean, I don't know how many times we just sat there and just like, let's try this. Let's try that. And then like it ended up on social media. And I think it's one reason, you know, like that kind of like exploration and being

experimental with things was like a really great for I think it worked really great for social media for us, but just in like our learning and our like Process and I was a young clinician when I mean, you know, you know, like I said I think in episode zero Joe or episode one where you know surprised you as you were one of my mentors so You know, it's nice to have that back and being able to spitball and then just kind of like I have this as a bonus But since we were talking about it now

Joe LaVa (13:11.074)
Yeah.

Joe Gambino (13:19.771)
you know, from, from your perspective, or my perspective, listening to you, I, you've always had great, the way that you speak with your clients, the questions that you ask. So, you know, everything that you kind of like bring up from that perspective. And I know even like questions I asked my clients today are things that we've talked about in the past, either one, like, w know, I came to see you at Encore or from Perfect Stride. And, know, I've been able to pull a few things from, from our conversations here on this podcast. So.

You know, I think that's probably some from you the bigger takeaways is just always about like your patient communication and how you're Empathizing with them and getting things across to them because it's definitely when people are in a lot of pain. It's I do believe that the way that we speak in the way that we talk to our patients Goes a long way because I've seen a whole lot of bad stories about You know doctors physical therapists chiropractors is saying something that puts a patient into a spiral so to speak

So I appreciate that as always Joe, doing good work over there. That's it.

Joe LaVa (14:20.258)
Yeah, make each other better, Make each other better. That's our motto. maybe hopefully we get a little bit more engagement from audience, patients and clinicians alike so they can join in on the banter in 2025. But yeah, I think that's our motto. Make each other better.

Joe Gambino (14:33.947)
Mm-hmm.

Joe Gambino (14:37.947)
That's it. Number two for us is for both of us is the people stories with their pain. So the guests that we've had and how it impacts what they've done. And I don't know, I think Stella and Clayton stood out to me the most because they both have these like very, very significant injuries that impacted like everything about them, especially Stella.

And just hearing these stories about how I've overcome it, which I think is like, it's not unique, but I feel like that, you know, not a lot of people can overcome very significant things like that the way that they did. So it was great to hear their stories of their struggles, how they overcome it, and then how it kind of brings them to where they are today. And I just think overall, like, you know, I mean,

Pain is such like a subjective experience. You're always in it in a sense. I've been in it for a very long time and you almost forget that other people experience it too. I think it kind of, hearing other people's stories like, maybe it's a little more normal than you would think to have pain, to struggle with pain and that there is potentially a way for you to kind of overcome it and get your life back. So I think that's a...

huge takeaway or you know stuff that I really enjoyed learning about or listening to this year.

Joe LaVa (16:03.682)
Yeah, mean, that's the other than what you take or how do you take your coffee? That is the only question we ask every single person. Yeah, actually, actually reading number three, it kind of ties into number two. So maybe we switch it and just, you know, realizing how amazing people's coffee creativity is. But let me get, getting ahead of myself. That's the only question we ask every single person.

Joe Gambino (16:08.271)
Yeah, yes. I'm surprised that's not on our list for you, Joe, because you seem to have got a lot of coffee takeaways this year.

Joe LaVa (16:31.67)
I know you singled out Mike and Clayton and I would totally agree. I think they were most open in their journey. And when you hear the struggles that they went through, I think that really connected hopefully with a lot of people listening that they were able to overcome so much and multiple setbacks, multiple flares, multiple, you know, unquote failures.

Joe Gambino (16:37.019)
Mm-hmm.

Joe LaVa (16:59.918)
throughout their whole process, but they just kept moving forward. And I think for both of them, it really kind of shaped the way they think, it them as people. And I think that's what makes them now such good coaches and clinicians. But I do think that we're always taught, hey, it's not necessarily about us. It's not sometimes quote unquote appropriate to share our stories. But I think

The question I ask a lot for people is, hey, do you mind if I share something about myself that relates to what you're saying? And I think that pain and injury just makes people feel so alone. And when you share a story from you, or you share a story from someone like Mike and Clayton and all they've been able to overcome, I do really think it makes a big difference to know, hey,

We said it in episode one or zero or wherever it was, right? We're not immune to the same things that we help the clients that come to see us. I still have pain. I still have fear and worry and doubt and anxiety and so do our clients. So if we're not able to connect at that level, then what's the point? Then people, think, still feel alone. They still look at us as these people who need to fix them. And, you know, I think that was

a really kind of cool thing to ask each, know, each guest that we had. And I think, you know, one of our other thoughts too, and maybe we can, you know, kind of push it into the new year also is actually just getting real life, you know, patients that we've worked with too, to share, you know, that similar idea of like, what do they wish they knew? Maybe that's their question, you know, Hey, where are you are now? And what do you wish you knew at the beginning of your rehab? You know? cause I think that would be kind of pretty powerful too, as like, you know, what were the key takeaways, but

Yeah, I think we were both pretty set on number two.

Joe Gambino (19:00.027)
Yes, 100 % agree there. Well, I mean, I think three, number three and number two are super, super tied together. So just run us right into it. Cause I don't know how much more we can add to it.

Joe LaVa (19:10.572)
Yeah, well, you know, I think if we just kind of tie in the idea that pain is an emotion, then your story is not going to only influence you as a person and maybe the way you think professionally, but it's going to influence the way you build your business. the way Clayton connects with his clients, the way Mike valued manual therapy so much because it made such a big difference for him. And now he

brings that to his clients. know, when, know, Courtney is so, you know, at first glance, you look at court and her website and her Instagram page and you're like, wow, it's so biomechanical. There's so much like nuance. yet Courtney and the things that she's been through in her life that she shared with us. I mean, she's crying and hugging every single person that she works with for the most part, or she's crying on zoom calls. And when we share clients.

You know, they say that and they say how much it means to them to be able to connect with somebody at that level. and it also happens to be their healthcare provider, you know? So I think that hearing, maybe this is the way to reframe it, like, but hearing each story affected the way that our coaches and other clinicians, you know, went about their practice. But then in so facto, maybe the other big takeaway was

hearing how patients responded to those emotions that these people bring. So it really does matter. I have a bias where I think it matters. You you might have a bias based on what we've talked about that you think it matters, but then, you know, we start bringing on all these guests and you can see how it matters to their business and their practice as well. So you kind of, again, start to realize, Hey, maybe this is just an important thing that we have to do. And I likened it to.

Joe Gambino (20:39.738)
Mm-hmm.

Joe Gambino (20:47.301)
Sure.

Joe LaVa (21:06.028)
you know, kind of smoking the other day with someone. Look, you're not going to get a gold medal because you don't smoke, right? So but or but if you do smoke, that's really bad. So it's sort of like same thing in health care, right? If you're an asshole, right? That's really bad for you and your practice. But if you're just a nice person, you're not going to get a gold star, right? It's just the standard. It's just what you should do.

And I think because it's fallen so far, you know, into the fringe world of healthcare almost, it's not viewed as that anymore. You know, or people will try it once or twice and be like, well, you know, that didn't work. There was no sense. All this patient did was cry. made me uncomfortable. So now I'm just going to go back to talking about their quad strength, you know, or their back endurance or this or that, or looking at one specific thing in a bubble. So maybe that's how we can flip it a little bit.

Joe Gambino (22:01.465)
Yeah, I do like that. it's one thing as you were talking about coming to think even like anybody, mean, if you were talking about pain as an emotion, you know, if someone work with someone they highly like, you everybody has a guy for something they highly recommend if they have a really good experience. Right. So I think it goes like just tying it all together. I like if someone's listening and they're looking for, know, maybe they're not.

Joe LaVa (22:19.02)
Okay.

Joe Gambino (22:29.209)
Overly happy or not with their with their experience or they're not seeing results. you know, finding somebody where they seem like that, unlike your initial encounter, where they don't just ask you about your pain, right? But they're actually asking you questions about how it's impacting your life and almost like getting a little personal in a sense, because I think that that layer of connection and understanding is really what allows people to connect and like buy into into it. but

Also, know, mean, like the ability for for, you know, that person that's trying to find a PT or someone that they trust. mean, like that trust factor is probably like the highest or the almost like the biggest thing. Like I don't remember where where I read it, but it's out there plenty. like, you know, you can get in a book somewhere, maybe in a paper. But.

Joe LaVa (23:20.033)
In a book.

Joe Gambino (23:24.795)
you trust is even more important than like the program that you put out there, you know, like you can have somebody like you can give them the exact thing that they need, but they hate you. They're not going to get better. Or you can give them like a mediocre program, but they love you and really trust you and believe that you're, you're going to be able to help them. And that seems to be a large part of things. So, you know, I think that, you know, if you're not really highly connected with the person that you're working with, you know,

try to find somebody that will if you're not seeing the results. Doesn't mean that if you didn't make that connection that they can't help you, but something to keep in the back of your mind as a listener. All right, number four, action comes before motivation. Now we've talked about this a whole lot and I feel like I've been talking about this a whole lot with clients. So I'll let you kick it off and we'll go from there. I actually have a question that's gonna probably make this a two-parter episode as opposed to a one-parter episode.

Joe LaVa (24:02.446)
Thanks for watching.

Joe LaVa (24:18.67)
Ooh, ooh, all right, cool. It was like a cliffhanger, come back for the last takeaway for the 2024 season. Yeah, I think that we talk so much about communication, connection, pain, all these things, but really at the end of the day, we're in sort of the business of helping people change behavior, whether that's mindset, movement, relationships, environment.

Joe Gambino (24:23.093)
Hahaha

Joe LaVa (24:47.336)
all of these things that can affect the way we perceive ourselves, our bodies, our pain, you name it. And so many people who I talk to each week are kind of waiting for motivation, like waiting for the thing that's going to kick them into creating these habits of where they want to be and the lifestyle they want. And I think one of the themes that came up with all of our guests is how they

typically have an action plan to help people with this behavior change. It's not just sitting around waiting for it to come to you. And I had a client yesterday that I was on a call with and she mentioned that she was sort of like in just this hoping strategy. Like I hope that the pain will just get better. But then when you sit down and ask her about her process week to week, there was no process. So it's like, want to make money. I want to get better at my job.

I can't just hope for those things. You know, I have to put together some sort of a plan. And I think that that really has been a thing that I've been pushing with a lot of clients who've decided to commit to that process. It's like, Hey, look, if we want to get to point C and we're at point A, we just have to get off of point A first. We have to find B. What does that look like?

Joe Gambino (26:09.306)
Mm-hmm.

Joe LaVa (26:12.93)
because there's so many little steps that are going to get us to where we want to be. And if it's too big, and there's always that picture that comes to mind of like a million little steps, you know, helps you achieve your goal. But if there's one step that's too big and you can't reach the top of it, well, then I just start walking back down in the direction I came because that's the only thing that makes sense. So I think it is about this idea of being happy with little wins, being more patient, but most importantly,

Putting something into practice, not waiting for the right time is I think where that action comes before motivation.

Joe Gambino (26:53.167)
Yeah, I like that. And just not like, you know, if someone stuck on A and having a hard time getting to B or C, I was actually talking to Clayton yesterday. And he was, we were talking about this thing where he was, he just put it into action. I don't know where he learned it from. But it was like he for, you know, he's trying to make some changes for himself. And he made a list of like all of his, you know, like current habits in a sense. So like your habit was like,

You know, I get home from work and I'm super tired and I can never like get into my workouts. Like that would be your habit. And then in like the next column next to it, you'd put the habit that you want to like start to build. So you're almost like highlighting like where you are, like your habits today and then where you kind of want to move to. And then you can like just pick one of them, right. And like start to like make a small change to move from A to B. so I don't know. mean, I had that conversation yesterday and just made me think about it. So don't know, maybe something like that might be helpful for someone if they're feeling like they're, they're stuck in a sense.

I'm trying to figure out what kind of habits, what kind of changes they can make. But just back to that, the point that you're making with, know, motivation comes after, you know, taking action in a sense. And, you know, the way I talked to my, all my clients about it is like, motivation will come and go, you know, you're to have these periods of motivation and you want to be able to capitalize on those periods when they happen. You don't want to be like, well, now that I'm motivated, I'm going to get into it. Right. Like,

Joe LaVa (28:10.104)
Hmm.

Joe Gambino (28:19.893)
January 1 comes everyone's gonna be motivated to get out of pain get back in the gym do all the things I want to do and if you were somewhat consistent during the holiday season and before that even if it wasn't perfect it's gonna be so much easier to just like let that snowball effect actually happen and like crush January right but if you're just trying to get into it now you have to like get into the habit build up that positive momentum because you had none before so I tell people money is made when like the motivation and the challenges are

are hard. If like work is crazy, family is crazy, you know, like all this stuff is going on and you're able to like find a way to like have some sort of consistency. A, you're going to be making some sort of progress or maintaining during those periods of time. But like once that period's over, you know how much easier it's going to feel to get that stuff in? Like it's going to be unbelievable. You know, so, always the conversation I always have is like, it's really hard right now.

Joe LaVa (29:08.238)
You

Joe Gambino (29:17.753)
do anything, do something because when that motivation comes back, when that time comes back and you feel like you have more capacity, it's gonna be so much easier for you to just continue to do the thing. And that's what makes long-term progress happen. So anyway, I'm gonna go to our question, my question to you, Joe. And this has been in the, I don't know if it's changing the way that I think, you know, it's personal experience for me, but I'm just gonna leave the question to you. How long...

Joe LaVa (29:29.827)
Yeah.

Joe Gambino (29:45.957)
do you think it takes for someone to make like actual significant changes to how their body feels it moves?

Joe LaVa (29:55.266)
Whoa.

Joe Gambino (29:55.375)
This is almost getting off of our five takeaways episode. So that's why I we might need two part for this.

Joe LaVa (29:59.788)
Yeah, or maybe we, that's a great one to consider and maybe just give a clean slate to. So maybe we move that to our next episode just because we only have one more takeaway. And then we have suspense building for all the listeners. Because I do think that's a good question. I think there's probably a lot of nuance into it.

Joe Gambino (30:15.451)
Hmm

Joe Gambino (30:20.399)
We'll give you the short answer and then if we feel like we need to expand and we want to do a episode, we can. Because I'm just curious where you are. I was going to ask you this question about the top, but we went elsewhere.

Joe LaVa (30:25.614)
Alright, fair enough. I... I... Yeah.

Joe LaVa (30:32.014)
Yeah, I had a question for you at the top too, but then I didn't want to get too far off. So now we have two ideas potentially. So I think honestly, my answer is instantly. I think when I'm done talking to people, working with people in a single session, they can instantly change how they move, how they feel.

Joe Gambino (30:34.031)
Hahaha

Joe LaVa (30:59.372)
The caveat to that is that I also know that that is fleeting. So we can instantly change someone's perception. It does not mean that those perceptions or behaviors won't creep back. Behavior change literature is all over the place. It's really unique. I always give a comparison of working with

like AA or NA, I have a few people in those programs. And I think that the reason behavior changes so hard and it's celebrated is because it takes so many different things to be successful. And if we think about those programs and you, you touched on it before, right? How trust is such a big part of the rehab process. So I can figure out the solution to back pain.

and put it in a program for people. But if I'm just handing it to them, yeah, maybe half the people implemented it they're like, my God, you're a genius. This is exactly what I came here for. But then the other half are like, well, no, I never really did it because you didn't explain it to me and I didn't really enjoy it. It was too hard. It was too easy. I didn't like exercise too, so I'd always skip it. So I think that with changing

perceptions, they're all based on what's happening in the here and now. We get it on this morning. Hey buddy, how you doing? Well, that's a loaded question. How did the kids sleep last night? did you and Jen have a fight this morning? were you able to get a workout in versus I ask you at 3 PM and you know, the kids are napping, you and Jen made up, you got your workout in, right? So just in the day alone, we're having so much high and low variability. So I think.

Consistency maybe takes 30, 60, 90 plus days. That depends on the individual. Some people need community and accountability. Other people, you know, will hear one thing and just suddenly change the way they think. I know I've done that before. I'm sure you have too. But what makes an idea sticky, I think is probably the real big thing. And that's what I try to do.

Joe Gambino (33:13.636)
Mm-hmm.

Joe LaVa (33:18.434)
with clients, what's going to stick? And I just hope that I have enough time to get to that sticky thought or sticky emotion. And yeah, I do the best I can. So I guess without going off too, too far, what do you think of that? And was that where you were also thinking or were you thinking more like structure?

Joe Gambino (33:28.047)
Mm-hmm.

Joe Gambino (33:40.187)
Yes, to a degree. Yeah. I mean, I completely agree with you. I think that, you know, you know, from a habit change, from, you know, buying even just like physically how they feel, you know, short term changes are quite easy to come by. Let everyone know, like, you know, you know, it may take us this long to get to this goal based on whatever they are, but we're going to see progress, right? You're going to feel different. You will know in the first couple of weeks of working together, right? You're not going to have to wait.

four months or six months or however long we're planning on working together to just like start to notice the change happen, right? But I guess more of like from like, you if we're just taking the physical nature and the anatomy of the human body, like someone needs mobility or someone needs strength, stability, whatever it is, right? Like actually making changes that stick around for a significant period of time.

Joe LaVa (34:34.806)
Yeah, weeks, months, years or never. You know, I think, you know, if we break it down by system, muscle and cardiovascular systems adapt the quickest. And then we're followed by probably all the other stuff, right? Then it's tendons and joints and capsules and blah, blah, blah. You know, those things take much longer, but then what do people experience all or most of their issues with? A lot of the white stuff.

Joe Gambino (34:48.219)
.

Joe LaVa (35:04.622)
the tendons, the joint space, right? So I think that's why sustainability with programming is so important and so important for people to understand. And I would say, funny enough, that was actually some nice, consistent feedback I got from people at the end of the year that, you know, their programming was, they were like, Hey, actually a lot of the stuff you gave me was much more simple than the Nike app, than the Peloton app.

Joe Gambino (35:14.299)
Mm-hmm.

Ahem.

Joe Gambino (35:33.285)
Mm-hmm.

Joe LaVa (35:33.794)
than these circuits I was doing in the past, but I wasn't breaking down. I wasn't getting hurt. I didn't have to stop for two weeks and recover. And I've noticed that even just when you write one rep extra a week, I'm always like, I could do more than this, but maybe there's a reason Joe's just writing do five by four, five by five, and then do a five by five plus week or something like that, and then reset ourselves.

So I've just been abiding by that because I trust the process now. Right. So again, it depends on what we're working with, but I think that's why, you know, walking programs, running programs, people are like, go gung ho about them. I start doing more and more and more. I feel good. I feel good. I feel good. I feel good. and then I have tendonitis, you know, or, you know, that, that joint impingement or arthritis starts bothering me because it takes longer for those tissues to adapt.

Joe Gambino (36:27.312)
Mm-hmm.

Yeah, that's, know, I was, mean, like, again, when we talk about, you know, change, you know, some sort of feel better change, or maybe short term is going to happen in the near future. But I, you know, I've been thinking about it because, you know, I sent you the, the squad just today is no, no real reason. But just to see, because, you know, when you're looking at like, I look at some of these things of myself and I'm like, you know, feels different to me. Right. But I don't know if I, if I like really see.

Joe LaVa (36:55.318)
huh.

Joe Gambino (36:57.851)
any real changes. So I sent it to you just to see what you would say more than anything else. But what I found like in like past programming for myself, you know, like I have all this stuff, you know, and I'm like, okay, well, for this, you know, I have, you know, do things in seasons, it's like two months or three months or four months. And I work on it and you start to feel a little bit better and things are moving and then you shift to the next thing and the next thing and the next thing. And I've been feeling pretty good. I mean, like there's been nothing overly wrong, but I've noticed like

know, squatting, even though I've been feeling pretty good, has always felt like very sticky at the bottom. You know, like it just feels tight, not painful, right? But just like, you know, I couldn't sit in a bodyweight squat like I used to and things like that. And maybe like two weeks ago, I was dropping Olivia off at daycare and I got down in the squat to like put her under a jack. And I was like, wait a second. Squat hasn't felt like this in a while.

You know, and then I've just noticed it like I'm like one pin lower a little, you know, like, and like the Anderson squats and like, okay, you know, feeling good, feeling a little stronger out of the hole, you know, I've struggled with a little hit, like, actual like, hip flexion in a degree and a lot of like hip extension. Like actually all extension work has been like a, like a game changer, but I've been doing it for like seven or eight months now, maybe a little longer, maybe it's like nine months now. So it was much longer than I would have had like, like normally.

I programmed it mainly because I don't program it anymore and someone else is doing it, it's just always there. And all of a sudden now I'm like, okay, well, even though I was feeling good and things were going well, just this constant repetition of loading rotation of my hips and loading extension and doing a lot more loading and strengthening of end ranges in a sense and how they program it, things are really just starting to like...

change from like a hip and back perspective and getting even like a level above where I normally was. So, you know, I guess I was just trying to figure out where your brain was because, I think depending on it all depends, right? Like some people may move really well and have pain and they don't need a whole lot of work to make change. But something like I was pretty limited in hip extension. I like, I've always known that and it took months and months and months, right? To get to a point where like, I'm like really starting to notice like significant change to how things are. there was

Joe LaVa (39:11.534)
Yep.

Joe Gambino (39:11.991)
longer than I may have like even thought in the past. So it might even be changing some of the way, depending on like how stiff somebody is or how long things are being going on. Like maybe I need to like even my own mindset and how I might educate someone might need to start to shift a little bit. So I just figured to talk about it, ask the question. Nope, nope, no correct answer.

Joe LaVa (39:29.262)
Alright, cool. So what was, was there a correct answer by the way then? No correct answer. How far apart were the two pictures that you sent me?

Joe Gambino (39:38.917)
a month.

Joe LaVa (39:40.62)
Which one was the newer one?

Joe Gambino (39:42.233)
the one with the hat.

Joe LaVa (39:44.304)
okay. All right. So then I said, my instant reaction was the one with the hat. I felt like you were further along just because you looked more relaxed there. That was my, and you, and then you yelled at me because then it was like, because the weight was different. was like, the weight is only 10 pounds, but I thought you just looked a lot more comfortable. And then I saw actually looking at it now going back and forth because you're wearing pants in one and shorts in the other. I also think you're, you're getting several inches deeper in the hat picture.

Joe Gambino (39:52.453)
Yes, apparently so.

I was just busting your balls.

Joe LaVa (40:14.35)
now that I actually really look at it.

Joe Gambino (40:16.943)
Now that I gave you the answer of which one felt better. biases exist, Joe. I see it. I see it now, Joe. You got me. Anyway, I just thought it was interesting and you know, just something that might be changing my perspective. Not a whole lot, but maybe a little bit just personal experience, my own biases, how I feel. and just maybe someone who's listening, if you've like tried a whole lot of things, you've seen some progress and then it goes backwards and forward and backwards and forward.

Joe LaVa (40:19.606)
Yeah. Yeah, well now I see it.

Joe Gambino (40:43.631)
you know, maybe just takes longer consistency and inputs to make some of those changes. So that's it. Let's move to number five and then we'll take it home from there. This is a good one. I actually forgot about this before you put it in the dock.

Joe LaVa (40:50.606)
Got it. Yep.

All right. think this, yeah, yeah. I think, you know, and this, this just goes back to our first guest we ever had, Tyler. And when he sort of said this, it just kept echoing over and over and over again. how number five for me was pain is a skill. Right. And you want to get better at squatting.

Joe Gambino (41:19.45)
you

Joe LaVa (41:24.512)
and deadlifting and your hip mobility and all of these things that we've either just talked about, we've talked about on the show throughout this year, we will continue to talk about in the months and years hopefully to follow. But I also think people just need to get better at understanding that, hey, you can shift your perception about your pain. Guess what? It's still gonna be there. Like you'll leave our interaction, you'll feel better.

Your hip mobility might be better in a couple of months, but you're still a pain client. You know, you still have, you know, the ACL injury. You still have the lumbar radiculopathy injury because it's a part of you now. Right. So when it comes back or yeah, I'd actually say when I think most people can agree and I can attest to this. know you can. I'll feel good for several months.

trading's going awesome, no signs of anything about to happen, and then I'm brushing my teeth and I'm laying on the floor because my back literally spasms so hard and I've never felt anything like that in my entire life. So what did I do wrong? Right, and that was the first thing. I was like, dang, what did I do? And then I had to reframe that. I didn't do anything. I've been feeling good, I've been working out, I've been eating okay, I've been sleeping good.

I have all these like little tracker variables now that helped me out and realize that. getting better at just accepting where you are day to day, I think is so important. And there's nothing that makes me happier than after a first interaction with a client. And this happened twice yesterday where they email me back and say, that conversation was already so valuable.

so helped me process what I'm going through differently. And then I always write back, you know, that is goal number one. I don't want us to forget all the things you told me and all the things you've been experiencing because those will stay with us. Now we just view them through a different lens and then we keep moving the goalpost forward. Right. We chase that goal. get to point B and then we see what path we need to get to see. It might be different. Right. And then just keep

Joe Gambino (43:23.621)
Mm-hmm.

Joe Gambino (43:38.511)
Mm-hmm.

Joe LaVa (43:47.328)
reevaluating. So yeah, that pain is a skill I think came through with every guest, every conversation. And I think that was probably a good last point takeaway for us.

Joe Gambino (43:59.676)
I'll leave us with two things and I'll let you take it home unless you have something you want to talk about after. you know, I agree with everything you say. I really take that as pain as a skill. I should probably use it more with my clients as an education point. But, you know, people who are in chronic pain, a lot, you know, they may not even have a lot of pain in the first place. But the goal is always like, I don't want to

any pain, I don't want to have any stiffness. And for some people that may not be a hundred percent realistic and that's where like having pain is a skill, like understanding where your body is, how can we make it better? And then when stuff does happen, what, you know, what should he do about it? Or what, you know, what kind of tools do you have? So navigating pain in itself, I 100 % believe is a skill.

Joe LaVa (44:28.076)
Yeah. Yeah.

Joe Gambino (44:49.871)
just to acclimate to understand. And I think if we set the expectations or your expectation is like, okay, well I've had pain for like five years. Maybe I can't get completely pain free, but your goal should then be like, well, how can I like go out and do the things that are important to me while having pain be as low as possible, right? So I can go enjoy life and like, okay, well, when I'm done, if my pain was like a one or two, like solo level where.

hardly noticeable, like is that really going to be like a make or break deal for you? And that's really like the acceptance and the skill portion of things I think is like, you know, that portion of things. And then the last thing I wanted to touch on is a, is a story that happened last night. And again, pain being a skill and tying it back into emotion. So I'm working with a client for, man, time has always escaped me because I feel like it goes so fast. I'm to say a year and a half or two. And if she's listening, she's going to probably say we've been working together and she's to be like, what the hell?

Joe LaVa (45:42.656)
Mm-hmm. Like seven. I knew you in high school!

Joe Gambino (45:45.339)
You know, yeah, we were working together for 10 years. but, know, so, you know, I originally saw her, she was recovering from a foot fracture. The pain was laying around for a really long time. She's doing really great. She's still got some foot soreness, but she's back to playing tennis. She can walk 20,000 steps. She can jump. She can do everything that she, she wants, things like that. And then last night she was out and, just, she like rolled her ankle.

and she had some pain, some swelling, things like that. And the pain was right over the fracture site. So I get messages, you know, she's nervous, she's fearful, you know, like she's not sure what's gonna happen. She's like, my God, this happened to me again. You know, she's like, I was like, well, could you do this, this and this? And I was like, okay, well, I really think that we need to do imaging. There's nothing here that tells me that we have to, there's no bruising, you're able to put some weight on it.

so I think we'll be okay. But if you feel, you know, it's going to be better for your understanding to just know that there's no break, then go out tomorrow and get an x-ray. And then lo and behold, after our conversation, she goes to sleep, she wakes up and she's like, you know, it looks, seems like it's a lot better today. Like I can put some weight on it. You know, it's not a swollen. she went through an x-ray, no break, no nothing, you know? So like now all of sudden, like she's in a much different place, but like that whole swing, right. And that happens to everybody. It happens to me when I back.

flares up and things like that. it's, think people should know like, no, feel what you, I tell people feel what you have to feel, right? Like that's, that's a normal part of the experience, but then take some time and process. we've talked about this on the podcast a whole bunch, but it's just another story that kind of highlights this stuff. It's like fear and apprehension because it almost felt like the old injury that she's been trying to recover from is still, you know, like impacted her life to a large degree. And she was worried that it would happen to her again.

Joe LaVa (47:21.665)
Mm-hmm.

Joe Gambino (47:36.845)
And then as she started to realize, okay, it's not as bad as it was when that happened and there's nothing here that's really nerve wracking. It's like annoying. have to like work on my ankle now, but she's in a much different place. So, you know, just highlighting that as well.

Joe LaVa (47:49.858)
Yeah. And can I just say something? That's intelligent. That is exactly what our bodies are supposed to do. So when I hear people tell me those stories, I say, this is how I know you're normal. This is how I know you can learn. This is how I know you can get out of this because you created a memory. You learned about there's an issue with your foot. You know the mechanism that hurt it before you did the same.

Joe Gambino (47:51.674)
Shoot.

Joe Gambino (47:56.795)
Hahaha

Joe Gambino (48:02.117)
Hahaha!

Joe LaVa (48:19.224)
Thing, if you were incapable of learning, if your body was incapable of adaptability, I would expect you to have rolled your foot and not thought a damn thing. so feeling what you're supposed to feel is important. And one of the stories I had yesterday with a client was like, she's like, just feel like I wanna, sometimes with this pain, go into my room, put my head in a pillow and scream. And I just don't do that. I just swallow it and I'm like, no.

Joe Gambino (48:32.187)
Yes.

Joe LaVa (48:48.49)
When we get off the call, I want you to walk into your bedroom, lock the door, scream as loud as you can, throw a pillow somewhere, hopefully against nothing fragile, and then see how you feel. Let your body process. Let your body cope. You should be angry. You've been dealing with this for 10 years. You should be frustrated. You've been dealing with this for 10 years. This is how I know you can learn. You're experiencing the correct emotion for the correct time.

Now we just want to not hit the button and make it go magically away. Turn the dial. Turn the dial down and then go from there.

Joe Gambino (49:28.459)
Well society tells us otherwise right so Yeah Start our own society Joe All right, man, well I got nothing left if you got something take it or take us home the the rest of road is yours Joe

Joe LaVa (49:31.894)
That's it. Fuck society. We're done. That's our closing remark of 2024.

Joe LaVa (49:43.734)
No, we're good, we're good. All right, well, Joe, it's been a wonderful year. Listeners, it's been a wonderful year. Joe, I love you. Thank you for everything over the last few months. Listeners, thank you. We hope you have a happy, healthy, safe holiday season, and we will see you again in 2025.