WEBVTT 1 00:00:03.799 --> 00:00:07.839 Welcome to Moving Conversations, a podcast for movement professionals, by 2 00:00:07.960 --> 00:00:11.240 movement professionals. If you coach, train, or teach movement, pilates 3 00:00:11.320 --> 00:00:14.119 or fitness, then this podcast is for you. With more 4 00:00:14.199 --> 00:00:16.839 than sixty years of experience and fitness and pilates, your host, 5 00:00:16.879 --> 00:00:19.239 Brian Ritchie and North Saint John explored to science of 6 00:00:19.320 --> 00:00:23.719 human movement, diving deep into the facts, myths, and common misconceptions, 7 00:00:23.960 --> 00:00:26.559 hoping to spark thought and conversation about how we view 8 00:00:26.600 --> 00:00:31.239 fitness and movement. Now let's jump into Moving Conversations and 9 00:00:31.359 --> 00:00:33.600 welcome back to Moving Conversations. I'm Brian Richie joining me 10 00:00:33.640 --> 00:00:35.600 as always is Noise, Saint John, Morty, Nora. 11 00:00:35.640 --> 00:00:39.039 How you doing very well, Brian. It's a beautiful day 12 00:00:39.320 --> 00:00:42.200 here in California. I'm home for a few weeks, which 13 00:00:42.240 --> 00:00:46.880 is kind of novel and delightful. I'm enjoying it. I'm 14 00:00:46.960 --> 00:00:50.039 enjoying just like getting back to a nice, steady routine 15 00:00:50.119 --> 00:00:53.560 of working out and eating well and moving. It's been 16 00:00:53.560 --> 00:00:54.119 really nice. 17 00:00:54.119 --> 00:00:58.359 How about you about the same. Yeah, it's I'm going 18 00:00:58.399 --> 00:00:59.960 to be home for a little while. I actually look 19 00:01:00.079 --> 00:01:03.560 to my whiteboard and looked at I had a client 20 00:01:03.560 --> 00:01:05.319 asked me today, so when's the next time. I was like, 21 00:01:05.359 --> 00:01:07.920 I'm here for a little bit. This is nice, all right, 22 00:01:07.959 --> 00:01:09.959 I'm gonna be I'm gonna be home. And then it's like, 23 00:01:10.040 --> 00:01:12.920 oh then I got boom boom, boom boom, and it's like, okay, 24 00:01:13.000 --> 00:01:15.280 I've got nine more events this summer and they all 25 00:01:15.319 --> 00:01:17.840 start at the end of July. So I'm like, Okay, 26 00:01:19.000 --> 00:01:20.680 that's going to be a little bit busy for the 27 00:01:20.719 --> 00:01:23.000 second half of the year. But hey, that's what we do. 28 00:01:23.079 --> 00:01:26.280 And last year I was front heavy. This year, I'm 29 00:01:26.280 --> 00:01:29.719 back heavy, so you know, And it'd be really nice 30 00:01:29.760 --> 00:01:31.239 if we could just spread it out and just do 31 00:01:31.439 --> 00:01:34.519 a little chunks here and there. But sometimes you just 32 00:01:34.560 --> 00:01:36.000 got to do when people can fit us in. 33 00:01:36.719 --> 00:01:40.000 That's the thing. That's the joy, the joy of our life. 34 00:01:40.079 --> 00:01:42.680 And if you all think this is glamorous, because I've 35 00:01:42.680 --> 00:01:45.400 been talking to people who clearly think that being an 36 00:01:45.439 --> 00:01:48.200 influencer is glamorous a little bit of In one of 37 00:01:48.200 --> 00:01:51.560 our other podcasts, it's like, ye, no, people, I'm sorry, man, 38 00:01:51.959 --> 00:01:54.680 but flying for twelve hours, ending up in a foreign 39 00:01:54.719 --> 00:01:56.879 country where you don't speak the language, ending up at 40 00:01:56.879 --> 00:01:59.760 some funky hotel and I've had some odd hotels. I 41 00:01:59.799 --> 00:02:03.319 have to tell you, as Brian, where you know the 42 00:02:03.359 --> 00:02:06.840 host books use somewhere. One time I really realized, like 43 00:02:07.000 --> 00:02:09.080 not long after I walked in, this was an old, 44 00:02:09.199 --> 00:02:12.919 old folks home. Basically, oh yeah, you're talking me about that. 45 00:02:13.439 --> 00:02:15.599 I wanted a lobby, and there was all these you know, 46 00:02:15.759 --> 00:02:18.400 older people sitting in chairs, and there was like a 47 00:02:18.439 --> 00:02:20.680 you know, a little aquarium over there, and some plants 48 00:02:20.680 --> 00:02:22.960 over there, and a little table for things like I 49 00:02:22.960 --> 00:02:25.599 don't know, majeong or whatever they play over there. Uh. 50 00:02:25.639 --> 00:02:28.039 And it was not a I don't know, it was odd. 51 00:02:28.080 --> 00:02:30.039 It was great. It was a nice, little comfortable, one 52 00:02:30.080 --> 00:02:33.400 bedroom sort of apartment thing, but it was not what 53 00:02:33.439 --> 00:02:34.919 I was expecting. We'll just say that. 54 00:02:36.520 --> 00:02:40.120 I remember one place I got booked into and I 55 00:02:40.159 --> 00:02:42.680 stayed with the owner of the company and he had 56 00:02:42.719 --> 00:02:44.319 a room, I had a room, and we had a 57 00:02:44.479 --> 00:02:49.520 few other people working with us. It may well have 58 00:02:49.520 --> 00:02:52.400 been called Bob's motel. I mean, it was just it 59 00:02:52.439 --> 00:02:55.400 was in San Diego. It was a mile and a 60 00:02:55.479 --> 00:02:58.680 half or something from the convention center, and obviously booked 61 00:02:58.680 --> 00:03:03.120 on one of these cheap website sort of things. It 62 00:03:03.199 --> 00:03:08.479 was so uncomfortable. The females revolted and refused to stay 63 00:03:08.479 --> 00:03:11.000 in the hotel. We had to put them up across 64 00:03:11.080 --> 00:03:12.599 the street from the airport. If any of you have 65 00:03:12.599 --> 00:03:17.319 ever been to the San Diego airport, the planes literally 66 00:03:17.439 --> 00:03:20.680 fly over this hotel. I'm sitting in the parking lot 67 00:03:20.719 --> 00:03:24.319 of the hotel. I look up. I'm hearing the vehicle 68 00:03:24.319 --> 00:03:27.159 I mean start shaking. I'm thinking, what is going on? Thinking, okay, 69 00:03:27.159 --> 00:03:30.960 California earthquake was my first thought. And then I looked 70 00:03:31.039 --> 00:03:33.719 up and I swear I saw the belly of a 71 00:03:33.759 --> 00:03:35.960 plane that looked like I could have reached out and 72 00:03:36.080 --> 00:03:39.039 grabbed it. It was so close. And I looked across 73 00:03:39.080 --> 00:03:42.159 the street and there was the runway, and I thought, wow, okay, 74 00:03:43.080 --> 00:03:47.080 this is just the way it is. So yeah, glamorous. 75 00:03:47.120 --> 00:03:49.360 It is not always. Occasionally we get put up in 76 00:03:49.479 --> 00:03:53.159 very nice places. Occasionally we have wonderful experiences on flights 77 00:03:53.159 --> 00:03:57.000 and can relax, and other times you're jumping between flights 78 00:03:57.000 --> 00:03:59.840 and you're sitting between two I remember, oh my gosh, 79 00:04:00.439 --> 00:04:03.159 I was in Germany. It was one of these you 80 00:04:03.159 --> 00:04:05.159 can book half of your flight, you can say where 81 00:04:05.159 --> 00:04:07.560 you want your seat, but then you get to your 82 00:04:07.560 --> 00:04:09.639 next thing, and I'm on Luftanza and you don't get 83 00:04:09.639 --> 00:04:12.960 a choice. I am literally between two guys. And this 84 00:04:13.039 --> 00:04:15.319 was when I was a bigger man. I was probably 85 00:04:15.360 --> 00:04:17.680 two hundred and eighty pounds at the time, and I'm 86 00:04:17.720 --> 00:04:20.680 sitting between two people and they'd call me small. 87 00:04:21.279 --> 00:04:24.759 Oh god, oh god. So you're like, shoulders are scrunched. 88 00:04:25.199 --> 00:04:28.079 They've they've taken over the hit the arm rests right like, 89 00:04:28.120 --> 00:04:30.959 they've totally taken over the arm mass, They've taken over everything. 90 00:04:32.560 --> 00:04:34.439 Oh my god. I didn't need to see because I 91 00:04:34.480 --> 00:04:36.600 wasn't moving. I was not going to move during this 92 00:04:36.680 --> 00:04:40.800 wedged I was wedged in there and they're passing sausages 93 00:04:40.920 --> 00:04:43.360 between them to eat in front of my face, and 94 00:04:43.399 --> 00:04:45.879 part of me was to say sure. I mean, I'm 95 00:04:45.920 --> 00:04:50.519 sitting here, they're speaking German, and I'm thinking, oh my gosh. 96 00:04:50.959 --> 00:04:53.399 Fortunately it was an hour and a half two hour flight, 97 00:04:53.399 --> 00:04:55.480 so I said, I can make it for that long. 98 00:04:55.519 --> 00:04:59.199 But oh my gosh. So yes, glamours, sometimes our travel 99 00:04:59.319 --> 00:04:59.560 is not. 100 00:05:01.839 --> 00:05:04.399 Oh my god, that's that's a perfect image. I'm in 101 00:05:04.480 --> 00:05:07.120 that image. 102 00:05:07.720 --> 00:05:12.600 So last week. Last week we talked with Beth about 103 00:05:12.639 --> 00:05:14.240 hip replacements. 104 00:05:14.160 --> 00:05:19.639 Right and a fire hose download everything you ever need 105 00:05:19.639 --> 00:05:22.240 to know. It was like so a lot. 106 00:05:22.079 --> 00:05:26.720 Of information of information, Oh my gosh. And I mean afterwards, 107 00:05:26.720 --> 00:05:28.839 as soon as we sort of stopped the podcast, we 108 00:05:28.879 --> 00:05:31.160 started talking and saying, Okay, we need to follow up 109 00:05:31.199 --> 00:05:35.560 because there was so much information that it's hard to 110 00:05:35.639 --> 00:05:39.040 parse that much in such a short period of time. 111 00:05:39.759 --> 00:05:42.399 But we also want to talk about things like case studies. 112 00:05:42.480 --> 00:05:47.560 I've had countless numbers of hip replacements and literally from 113 00:05:47.600 --> 00:05:50.279 everything you can imagine. So I was thinking, Okay, it'd 114 00:05:50.319 --> 00:05:52.000 be a good idea. I'm sure you had the same 115 00:05:52.480 --> 00:05:55.639 to be able to break that down and go over 116 00:05:55.720 --> 00:05:58.240 these things and also talk about the differences between the 117 00:05:58.319 --> 00:06:03.439 techniques and the positives the negatives there are, and these 118 00:06:03.439 --> 00:06:07.240 are things that, let's face it, with our clients, a 119 00:06:07.319 --> 00:06:09.560 lot of times, if they're going to go into surgery, 120 00:06:10.040 --> 00:06:13.800 they look to us for guidance, for help for opinions 121 00:06:14.199 --> 00:06:18.439 because we see the rehab afterwards, we know the surgeries, 122 00:06:19.040 --> 00:06:21.720 and a lot of times they think, well, this doctor 123 00:06:21.759 --> 00:06:25.399 wants to do this brand new technique and I'm like, 124 00:06:26.839 --> 00:06:29.680 how many of the have they done? Five? 125 00:06:30.759 --> 00:06:37.120 Okay, it's called practicing, which at this point I would 126 00:06:37.240 --> 00:06:40.399 rather say they've done two hundred, I'm great, Okay, good, 127 00:06:40.480 --> 00:06:42.560 then I'm going to be two hundred and one. I'm 128 00:06:42.600 --> 00:06:45.120 happy to do that. To be number three or four 129 00:06:45.680 --> 00:06:48.120 of a new, brand new procedure. They're all excited about. 130 00:06:48.480 --> 00:06:53.839 They'll be paying extra attention. But their experience, Yeah, they're learning. 131 00:06:53.920 --> 00:06:55.920 Their experience isn't is it where it is with a 132 00:06:55.920 --> 00:06:57.800 more familiar routine. 133 00:06:58.319 --> 00:07:02.120 And you said the magic number. I had a surgeon 134 00:07:02.240 --> 00:07:04.879 client for a number of years and he said, you 135 00:07:04.879 --> 00:07:09.360 know what two hundred is proficiency? He said, after that 136 00:07:09.600 --> 00:07:10.279 is artistry. 137 00:07:10.879 --> 00:07:11.040 OK. 138 00:07:11.199 --> 00:07:14.680 But at two hundred, that's when you are as proficient 139 00:07:14.759 --> 00:07:17.560 as you're going to be with the technique. You become 140 00:07:17.639 --> 00:07:21.720 a master after that. But that's sort of the minimum number, 141 00:07:22.079 --> 00:07:24.680 almost like we've all heard the ten thousand hour thing. 142 00:07:24.720 --> 00:07:26.839 Whether or not that's true, I don't know. But he 143 00:07:26.920 --> 00:07:31.240 said two hundred in medicine, according to him, was the 144 00:07:31.279 --> 00:07:34.000 magic number. Anything after that. So he always told me 145 00:07:34.240 --> 00:07:37.360 ask how many they do? How many do you do here? 146 00:07:37.439 --> 00:07:40.240 How many years have you been doing this? Because if 147 00:07:40.279 --> 00:07:42.360 you hear someone's been doing this for only three or 148 00:07:42.360 --> 00:07:45.439 four years and they do, you know, one a week, 149 00:07:46.319 --> 00:07:49.519 few a month, maybe you want someone with a little 150 00:07:49.519 --> 00:07:55.720 bit more experiencing under the scalpel. Maybe that's just my thought. 151 00:07:56.519 --> 00:07:59.959 It's such good information generally, because so many of us 152 00:08:00.120 --> 00:08:04.160 don't know what to ask a surgeon. Oftentimes if it 153 00:08:04.199 --> 00:08:07.319 is something like a hip replacement, typically, well, there's a 154 00:08:07.319 --> 00:08:09.120 lot of ways as goes. But you start with like 155 00:08:09.160 --> 00:08:12.199 your GP or whatever your gatekeeper is on your insurance. 156 00:08:12.600 --> 00:08:15.040 They send you to some orthopedic person who may be 157 00:08:15.959 --> 00:08:19.600 a general practitioner who's specializing orthopedics, not a surgeon, right, 158 00:08:19.639 --> 00:08:21.879 They kind of talk you through the whole process. Then 159 00:08:21.920 --> 00:08:24.920 you end up at the surgeon's office, oftentimes seeing the 160 00:08:24.959 --> 00:08:27.720 surgeon briefly and then seeing their PA or their physician's 161 00:08:27.720 --> 00:08:32.879 assistant for every other session. So those questions, don't you're 162 00:08:32.879 --> 00:08:34.799 always get opportun to ask those questions. And I don't 163 00:08:34.840 --> 00:08:37.759 know about you, but what is the best source of 164 00:08:37.840 --> 00:08:40.799 even finding a good surgeon? I ask my friends, I 165 00:08:40.879 --> 00:08:44.600 ask the doctor friends that I know, right, like, how 166 00:08:44.639 --> 00:08:47.399 do you find somebody who's good? And of course then 167 00:08:47.799 --> 00:08:49.519 a surgery you probably want them to be on your 168 00:08:49.559 --> 00:08:52.720 insurance plan too, because that helps a whole lot spending 169 00:08:52.879 --> 00:08:56.759 for your fifty thousand dollars for a self pay surgeon. 170 00:08:57.519 --> 00:08:59.519 But those things are always a little tricky. So I 171 00:08:59.519 --> 00:09:01.399 think that's a really good just rule of fune, Like, 172 00:09:01.399 --> 00:09:03.360 how many of these have you done just out of curiosity? 173 00:09:05.919 --> 00:09:10.320 Yeah, And I don't know about you, but with my clients, 174 00:09:11.159 --> 00:09:13.840 all of them see the best doctors in the world, 175 00:09:14.519 --> 00:09:18.200 according to them. My guy's the best, My guys the best. 176 00:09:18.240 --> 00:09:21.480 I hear this, and maybe it's an error area that 177 00:09:21.960 --> 00:09:26.200 I'm in Washington, d C. High political influence. Everyone's trying 178 00:09:26.200 --> 00:09:28.399 to one up each other. Everybody has the best of 179 00:09:28.440 --> 00:09:30.840 the best of the best. And I see this doctor, 180 00:09:30.879 --> 00:09:33.320 I see this doctor, and they're the best. And you 181 00:09:33.399 --> 00:09:36.840 see these lists in magazines saying top docs and all 182 00:09:36.840 --> 00:09:40.279 of this, and I think, okay, well, not everyone can 183 00:09:40.320 --> 00:09:44.679 be the best. No, I want a really good mechanic. 184 00:09:45.039 --> 00:09:48.200 I don't need an F one mechanic working on my truck, 185 00:09:48.639 --> 00:09:51.679 but I want a darn good mechanic working on it. 186 00:09:52.360 --> 00:09:54.840 You know. I want someone working on my body who's 187 00:09:54.840 --> 00:09:58.120 done a ton of these, who's incredibly proficient, who's really 188 00:09:58.200 --> 00:10:01.600 good at answering my questions, and who's available to me 189 00:10:01.840 --> 00:10:05.519 and can answer those questions, and not necessarily someone who's 190 00:10:05.960 --> 00:10:08.039 the king of the world. When it comes to this 191 00:10:08.159 --> 00:10:11.480 because a lot of those bedside matters not the greatest 192 00:10:11.600 --> 00:10:13.879 and you may not get the questions answered that you 193 00:10:14.000 --> 00:10:14.639 really need. 194 00:10:15.840 --> 00:10:18.399 Well, you know, it's we talked a little bit about 195 00:10:18.399 --> 00:10:21.399 that with influence versus educators, Right, It's kind of like 196 00:10:21.519 --> 00:10:23.639 are they doing the work or are they talking about 197 00:10:23.639 --> 00:10:26.559 doing the work? Yeah, you know, because I know I 198 00:10:26.559 --> 00:10:29.039 look at a lot of those those best doctors of whatever, 199 00:10:29.080 --> 00:10:31.519 and generally there are things like plastic surgeons and things 200 00:10:31.519 --> 00:10:33.559 like that, which I understand because those those I mean, 201 00:10:33.559 --> 00:10:36.240 those guys have to market because they're generally not covered 202 00:10:36.240 --> 00:10:38.840 by insurance and it really is a product that they 203 00:10:38.879 --> 00:10:41.679 have to sell. But you know, hip replacement not so much. 204 00:10:42.200 --> 00:10:44.679 And that is really where you kind of want want 205 00:10:44.679 --> 00:10:46.320 the person who has a lot of experience with it 206 00:10:46.360 --> 00:10:49.679 and is really confident and confident with it, and they're 207 00:10:49.679 --> 00:10:51.879 again too referrals. If you've got a lot of clients 208 00:10:51.879 --> 00:10:55.200 who've had that, ask them, ask them who's you know, 209 00:10:55.360 --> 00:10:57.480 how did this turn out? Or you have a client 210 00:10:57.480 --> 00:11:00.159 who had really good results who is resurgent. Keep those 211 00:11:00.279 --> 00:11:03.559 names in your rolodex. Oh my god, yes, just really 212 00:11:03.639 --> 00:11:07.480 seriously dated me. Okay, not your rolodex in your phone, 213 00:11:07.919 --> 00:11:13.279 keep the contact in your phone under medical professionals, because 214 00:11:13.279 --> 00:11:15.759 that's really super helpful too, to have a list of people. 215 00:11:15.799 --> 00:11:17.440 We'll try this guy, try that guy. Maybe they're on 216 00:11:17.480 --> 00:11:19.399 your insurance. Whatever the situation is. 217 00:11:20.159 --> 00:11:24.720 No question. I think having that referral source is incredibly important, 218 00:11:26.039 --> 00:11:29.279 incredibly important. And in today's technology we talked about this 219 00:11:29.320 --> 00:11:33.919 with Beth. In today's new technologies, things are coming out 220 00:11:34.000 --> 00:11:36.799 all the time. I remember I had a client who 221 00:11:36.799 --> 00:11:38.279 was going for a hip replacement. He was in his 222 00:11:38.360 --> 00:11:41.960 early seventies, maybe mid seventies, and he was going for 223 00:11:42.039 --> 00:11:44.679 a hip replacement. And it was a new technique and 224 00:11:44.720 --> 00:11:48.200 this was before the anterior approach became much more utilized, 225 00:11:48.480 --> 00:11:51.720 and it was more truly a lateral approach. It wasn't 226 00:11:51.720 --> 00:11:55.320 the posterior ladder. It was a lateral approach. And this 227 00:11:55.360 --> 00:11:59.759 guy actually invented the technique, according to my client, and 228 00:12:00.320 --> 00:12:02.320 I thought interesting, and he showed me a scar and 229 00:12:02.360 --> 00:12:04.600 it was a very unique scar. It was like an 230 00:12:05.559 --> 00:12:09.360 almost like a seven. It was a right angle and 231 00:12:09.399 --> 00:12:13.840 it was small and it was truly lateral. And this 232 00:12:13.919 --> 00:12:16.679 guy had his version. And I've seen that there are 233 00:12:16.679 --> 00:12:19.759 other lateral approaches out there, and it was very interesting 234 00:12:19.799 --> 00:12:22.919 to sort of see that. But I've thought, Okay, how 235 00:12:22.960 --> 00:12:26.840 many has the person done? How good was it that 236 00:12:27.080 --> 00:12:30.279 my client had wonderful results? But he wasn't an athlete. 237 00:12:30.279 --> 00:12:32.399 He wasn't someone who was going to go out there 238 00:12:32.399 --> 00:12:34.720 and try and run or play tennis or golf or 239 00:12:34.759 --> 00:12:37.639 anything like that. He just wanted to be out of 240 00:12:37.639 --> 00:12:41.799 pain from arthritis. So with technology and a lot of 241 00:12:41.799 --> 00:12:46.159 people trying to you know, make themselves better, more proficient 242 00:12:46.279 --> 00:12:51.480 or whatever, techniques are going to be evolving. And we're 243 00:12:51.519 --> 00:12:53.600 in a state now where things are evolving a lot 244 00:12:53.639 --> 00:12:56.720 more robotics. I'm hearing a lot about that, especially when 245 00:12:56.759 --> 00:12:58.440 I'm in Asia. I'm sure you have. 246 00:12:59.240 --> 00:13:02.960 Yep, the other thing too, the robotics. There's also something 247 00:13:02.960 --> 00:13:06.159 that Beth mentioned which I thought was really interesting was 248 00:13:06.279 --> 00:13:10.799 a much better ability to visualize the acetabulum and the 249 00:13:10.799 --> 00:13:14.159 femur head and the geometry of that and replicate that, 250 00:13:14.519 --> 00:13:16.720 you know, through like three D printing other kinds of things. 251 00:13:16.879 --> 00:13:19.679 And that was fascinating because I know years ago it 252 00:13:19.720 --> 00:13:22.440 was kind of like, well, there's however many sizes and 253 00:13:23.200 --> 00:13:25.559 you're you're somewhere between a two and a three, But 254 00:13:25.600 --> 00:13:27.639 we don't have a two and a half, so we're 255 00:13:27.639 --> 00:13:29.120 gonna make a choice to give you a two or 256 00:13:29.200 --> 00:13:31.519 the three, right. I mean, that was that was kind 257 00:13:31.519 --> 00:13:34.799 of where it was, and that sometimes meant that the 258 00:13:34.879 --> 00:13:38.679 results weren't fantastic just because the hip didn't fit very 259 00:13:38.720 --> 00:13:41.519 well and didn't work out absolutely quite like the other one, 260 00:13:41.559 --> 00:13:44.840 or the mechanics changed between the two sides. So that's 261 00:13:44.879 --> 00:13:46.600 really wonderful. I mean, those are some those were some 262 00:13:46.639 --> 00:13:49.559 really good news that she brought that things have improved 263 00:13:49.600 --> 00:13:52.559 the player. There's much more customization, which is awesome because 264 00:13:52.600 --> 00:13:54.399 that will make a big difference in people's outcomes. 265 00:13:54.440 --> 00:13:57.120 I think I presume, I would assume. 266 00:13:57.639 --> 00:13:58.200 I do. 267 00:13:58.559 --> 00:14:01.480 I do know that twenty years years ago they said 268 00:14:01.480 --> 00:14:04.120 that quarter of an inch to half an inch of 269 00:14:04.240 --> 00:14:08.480 leg length discrepancy was fine and still functional, and that's 270 00:14:08.480 --> 00:14:12.600 still a successful surgery. And I thought, man, that's a 271 00:14:12.960 --> 00:14:16.799 large number. Anybody who's ever had a leg length discrepancy 272 00:14:17.120 --> 00:14:19.840 will know that a quarter of an inch can be 273 00:14:20.480 --> 00:14:23.679 huge on the low back, on your spine, on everything 274 00:14:23.759 --> 00:14:27.519 that comes above and below it. And one of my 275 00:14:27.600 --> 00:14:30.480 clients had after a hip replacement, I think it was 276 00:14:30.600 --> 00:14:32.519 a little more than half an inch and had to 277 00:14:32.600 --> 00:14:35.639 have every one of their shoes had a new sole 278 00:14:35.679 --> 00:14:38.559 put on. You'd never know by watching them walk, but 279 00:14:38.679 --> 00:14:41.320 sure enough they showed me their shoes and I thought, oh, yeah, 280 00:14:41.759 --> 00:14:44.120 they definitely had a different sole on one side to 281 00:14:44.120 --> 00:14:45.440 the other. And they said, yeah, it's a pain in 282 00:14:45.480 --> 00:14:47.200 the butt every time I buy new shoes, I gotta 283 00:14:47.240 --> 00:14:52.080 go and have this custom on the outside, not the inside, 284 00:14:52.080 --> 00:14:55.519 on the outside sole of the shoe to make it higher. 285 00:14:56.039 --> 00:14:59.000 And I thought, wow, all because they were sort of 286 00:14:59.200 --> 00:15:02.720 those in between sizes. She was in the matter of field, 287 00:15:02.720 --> 00:15:04.799 and she said, yeah, they brought in three from what 288 00:15:04.840 --> 00:15:07.480 the doctor said, and so they made the best determination 289 00:15:07.559 --> 00:15:11.360 based on what they saw. I thought, man, that's and 290 00:15:11.519 --> 00:15:15.000 when we think about hip geometry, you know angle of 291 00:15:15.039 --> 00:15:19.120 the of the femeral neck, you know the twist. Is 292 00:15:19.159 --> 00:15:20.919 it a little forward, is it a little backwards, is 293 00:15:20.960 --> 00:15:24.559 it turned? There's so many variations that you can't just 294 00:15:24.600 --> 00:15:26.519 go in and say, well, this is going to be 295 00:15:27.120 --> 00:15:29.360 everybody says the same. No, they're really not. 296 00:15:29.440 --> 00:15:32.879 No, not at all, not at all. So when I 297 00:15:33.320 --> 00:15:35.559 and again, you've you've probably worked with more hip replacements 298 00:15:35.559 --> 00:15:36.840 than I have. I've worked with a few, but I 299 00:15:36.840 --> 00:15:39.159 think you've worked with more of them for more time, 300 00:15:39.799 --> 00:15:41.600 and certainly more recently because I haven't worked with a 301 00:15:41.679 --> 00:15:44.200 lot recently. But one of the things that I often 302 00:15:44.240 --> 00:15:46.440 say about hip replacements is, and this is based on 303 00:15:46.440 --> 00:15:48.200 all the people that know that have had them, some 304 00:15:48.279 --> 00:15:51.120 of them are clients, some of whom are friends, it 305 00:15:51.159 --> 00:15:54.000 is when it is a successful surgery, it is a 306 00:15:54.039 --> 00:15:57.200 successful surgery. Yeah, you know, I have so many friends 307 00:15:57.240 --> 00:15:59.720 who especially went in in very good shape. These are 308 00:15:59.759 --> 00:16:05.159 general pilates, teachers, serious athletes, you know, movement people go in, 309 00:16:05.519 --> 00:16:08.480 have the surgery, do really good rehab on themselves, and 310 00:16:08.559 --> 00:16:11.120 come out able to do anything they want to do. 311 00:16:11.440 --> 00:16:13.200 You know, one of them that I often think of 312 00:16:13.840 --> 00:16:16.360 as a massive skier. I mean she does hella skiing 313 00:16:16.399 --> 00:16:20.960 and backcountry skiing several several you know days every winter. 314 00:16:22.159 --> 00:16:26.120 And this is like, this is what's possible, right, So 315 00:16:26.480 --> 00:16:29.000 I think that's the good news in a way, this 316 00:16:29.120 --> 00:16:33.440 is what's possible now with hip replacements. But and you know, 317 00:16:33.480 --> 00:16:35.759 in the butt is what I said in between there, 318 00:16:35.799 --> 00:16:38.159 which is she was in really good shape when she 319 00:16:38.200 --> 00:16:42.320 went in, and she did really diligent rehab on the 320 00:16:42.440 --> 00:16:45.679 back end, and she knew what to do, and she 321 00:16:45.720 --> 00:16:48.399 went way beyond what the physical therapist said. She went 322 00:16:48.480 --> 00:16:53.039 way beyond you know what the standard protocol is and 323 00:16:53.200 --> 00:16:57.720 really worked to regain as much function, stability, strength, mobility 324 00:16:57.759 --> 00:16:59.759 as she could after the surgery. 325 00:17:00.960 --> 00:17:03.600 I think we're in a We're in an age now 326 00:17:04.119 --> 00:17:08.000 that the baby boomers are more of our clients. I'm 327 00:17:08.039 --> 00:17:11.079 a gen X, but baby boomers are more of our clients, 328 00:17:11.720 --> 00:17:15.160 and I think they have, unlike their parents, I think 329 00:17:15.200 --> 00:17:17.119 they have greater expectations of what they're going to be 330 00:17:17.200 --> 00:17:22.720 doing for the rest of their lives. I think that statistically, yeah, 331 00:17:22.799 --> 00:17:25.160 they want to they want a hell ski, they want 332 00:17:25.200 --> 00:17:28.480 to go skiing. It's like I've worked for so many years. 333 00:17:28.599 --> 00:17:30.680 I'm retired. Now I want to travel. I wanta da 334 00:17:30.720 --> 00:17:32.599 da da da da da da da da da. And 335 00:17:32.920 --> 00:17:37.079 they have those expectations and to be limited by something 336 00:17:37.119 --> 00:17:40.160 like a hip replacement or a knee replacement or whatever, 337 00:17:40.200 --> 00:17:42.519 it's sort of like new I'm not going to be 338 00:17:42.559 --> 00:17:46.200 limited because I need I have things I want to 339 00:17:46.200 --> 00:17:48.039 do and need to do. I've got my bucket list 340 00:17:48.079 --> 00:17:51.839 and I need to do them. So I think previous 341 00:17:51.920 --> 00:17:55.599 generations were much more Oh, I'm sixty five, I'm going 342 00:17:55.680 --> 00:17:58.240 to retire. I'm going to sit at home now, I'm 343 00:17:58.240 --> 00:18:01.480 going to sit in my rocking chair. And that's not 344 00:18:01.599 --> 00:18:04.079 what we're seeing. We're really seeing the people who want 345 00:18:04.119 --> 00:18:05.440 to push their bodies. 346 00:18:06.279 --> 00:18:08.839 And also who are and this is statistically true too, 347 00:18:09.519 --> 00:18:13.640 hip replacements are happening a lot younger. Yeah in people right, 348 00:18:13.680 --> 00:18:16.160 that used to be like, you know, you're seventy two, 349 00:18:16.240 --> 00:18:17.880 you fail, you broke a hip, We're going to replace 350 00:18:17.880 --> 00:18:21.240 your hip. Now it's you know, somebody who's fifty five. 351 00:18:21.559 --> 00:18:25.200 They've been as serious whatever they've been doing, and they 352 00:18:25.200 --> 00:18:27.079 need a hip replacement because they want to keep doing 353 00:18:27.079 --> 00:18:29.680 what they're doing. But they're fifty five, and you know, 354 00:18:30.000 --> 00:18:33.160 any joint replacement that they talk about has a lifespan 355 00:18:33.480 --> 00:18:36.440 and sometimes they can last kind of forever, but sometimes 356 00:18:36.519 --> 00:18:39.559 they really don't last forever for a variety of reasons. 357 00:18:40.279 --> 00:18:44.200 And so the younger somebody is, the more you really 358 00:18:44.200 --> 00:18:48.400 want to make sure that that hip replacement, that prothesis 359 00:18:48.480 --> 00:18:52.079 is protected as long as possible, so you really maintain 360 00:18:52.400 --> 00:18:55.319 good mechanics there so that doesn't wear out any sooner 361 00:18:55.359 --> 00:18:55.960 than it needs to. 362 00:18:57.119 --> 00:18:59.119 And that's a great question you just brought up, is 363 00:18:59.160 --> 00:19:02.799 when do you do ooh a hip replacement because the 364 00:19:03.200 --> 00:19:09.160 traditional twenty years ago, I had this happen countless times 365 00:19:09.599 --> 00:19:12.039 where a client would suddenly come in with a cane 366 00:19:12.559 --> 00:19:16.000 and I'd say huh okay, and they say, yep. The 367 00:19:16.039 --> 00:19:18.440 doctor said, use this cane and when the pain gets 368 00:19:18.440 --> 00:19:21.200 too bad, then we'll do the replacement. And it usually 369 00:19:21.240 --> 00:19:23.799 was two to three months after they were given the cane, 370 00:19:24.359 --> 00:19:26.920 because they went in the doctor said, yep, the arthritis 371 00:19:27.039 --> 00:19:30.359 is bad. Maybe you're ready for it, maybe you're not. 372 00:19:30.880 --> 00:19:33.279 And usually it was a mental component. Usually the person 373 00:19:33.359 --> 00:19:35.160 wasn't really ready for it yet. They wanted to be 374 00:19:35.160 --> 00:19:37.000 out of pain, but they weren't quite ready for a 375 00:19:37.079 --> 00:19:40.319 surgery because in their mind this is so huge, and 376 00:19:40.400 --> 00:19:42.599 they were said, here, here's a cane. When the pain 377 00:19:42.599 --> 00:19:44.799 gets too bad and you're ready, we'll do the surgery. 378 00:19:45.839 --> 00:19:49.960 And so that was really a big question, is when 379 00:19:50.000 --> 00:19:54.559 do you do it? Now. I'm having clients approach me saying, look, 380 00:19:55.279 --> 00:19:59.200 I'm sixty five years old, I've just retired, my hip 381 00:19:59.240 --> 00:20:02.359 is killing me. I have so much I want to do. 382 00:20:03.599 --> 00:20:06.119 It's not the doctor says, I can probably put it 383 00:20:06.160 --> 00:20:07.880 off another four or five years, but then I'm going 384 00:20:07.920 --> 00:20:09.759 to be older and I'm not going to be as 385 00:20:09.839 --> 00:20:13.119 strong and this and that. Is it better to do 386 00:20:13.160 --> 00:20:17.119 it while I'm younger and I can recover faster, or 387 00:20:17.200 --> 00:20:20.599 is it better to wait? And it's one of those 388 00:20:20.720 --> 00:20:24.079 questions I'd say, I don't have the right answer for 389 00:20:24.160 --> 00:20:26.000 every single client, because everybody's different. 390 00:20:27.559 --> 00:20:29.799 My sister had a knee replacement about a year and 391 00:20:29.839 --> 00:20:32.200 a half ago, and it was exactly that question in 392 00:20:32.200 --> 00:20:35.480 her mind. So she was, let's say, howld on. She's 393 00:20:35.480 --> 00:20:38.359 probably seventy two or three at the time, and the 394 00:20:38.440 --> 00:20:41.119 doctor said, well, you know, yeah, your knee has has 395 00:20:41.160 --> 00:20:43.079 been bone on bone for a while at that point, 396 00:20:43.160 --> 00:20:47.640 so clearly it was in a pathological state where a 397 00:20:47.720 --> 00:20:51.480 replacement would be a useful thing, and a pain state too. 398 00:20:51.559 --> 00:20:54.359 She was, you know, on pretty regular anti inflammatories, and 399 00:20:55.640 --> 00:20:57.920 she she was that same calculus because she could. She 400 00:20:58.039 --> 00:21:00.880 was pretty functional again, she's a plate she plots, mover, 401 00:21:01.039 --> 00:21:03.480