Deep Dive
Shownotes Transcript
What's up, everybody? Welcome back to The Honest Drink. I'm Justin. You can always reach us at thehonestdrink at gmail.com. And if you've been enjoying this podcast, go ahead, rate, comment, and subscribe. Our guest today is the Senior Physiotherapist at Sino United Health. She specializes in the management of joint pain, sports injuries, sports performance, and rehabilitation.
She is very passionate about pain and injury prevention. Many of her clients are ex-Olympians, Qigong world champions, Spartan elites, and triathlon competitors. It was a very down-to-earth conversation, and she was incredibly honest. We got to do some myth-busting and talk about some commonly debated topics around health and exercise.
We learned some new tips, had a few laughs, and came out much more informed on how to maintain our bodies and manage our physical pain, whether you're competing in a sport, working out, sitting at the office, or given current events, staying at home. We had a great time talking. She's very open and direct, which I love. So, without further ado, please welcome Oni Xie. ♪
Cheers. Cheers. Cheers. Welcome to the show, honey. Thank you. Thank you.
We're drinking today the DeWars 15 blended scotch whiskey. It does have a little bit of smoky flavor to it. A little bit. Yeah. What? No, I was just, I was like, the way you greeted Oni for the first time and you're like, is it A-O-N-I? No, because there's an A in her name and I kept thinking it was like A-O-N-I and I couldn't really hear her.
Anyway, it was funny. Your name is Oni. Oni, yeah. I'm meeting you for the first time, right? So like what's...
Like what's your experience with this? Like what's your resume like? My resume? Yeah. So I graduated and then I was working in Sydney for a few years. And then the opportunity came for me to come to Shanghai. So I worked here for a little bit. And then I felt that at the time, I felt that I was too underqualified to be seeing like patients. I felt like I wasn't supported or supervised. Like I had a lot of more learning to do.
So then I went to UK and then worked there for one, two years, one and a half years. Yeah. And then I came back to Shanghai again.
So why do you keep coming back to Shanghai? Like, why did you just know Shanghai was a place you wanted to start a career? Not really. More for my grandparents. So it's more like I want to spend some time with my grandparents. Because part of it was when I was back in Australia, I was working in geriatrics. And I felt like a bit sad that I was helping all these other elderly people. So they were like in their 70s, 80s.
And I was like being their granddaughter, but I wasn't there for my own grandparents. So I really wanted to, cause I'm quite close with them. So I really wanted to kind of spend some time with them. - So it was like a sense of guilt. - Yeah. - That brought you over here. - Yeah, yeah. - Well, so now you're working with like ex Olympians, professional athletes, things like that. Like how do you get from a place where you thought you were under qualified to now working with like elite athletes and like Olympians?
I probably still feel quite underqualified for sure. I think I'm always the type of person who will feel like I'm not good enough for this. Why is that though? You honestly feel that way or have you done any self-reflection to like to find out like why it is you feel that way? Well, I mean like I've got a lot of...
I know a lot of passionate people in my life and I feel like they're really like into their job. And then they will be like doing research out of working hours. Like, you know, really kind of drilling into the stats and then reading up on the journal articles. Like I'm not that type of person. Like I'll have my bouts where I'll be like, okay, like, you know, I got to study hard, look up on the new evidence. And now I'll have bouts where I'm like, oh, I just want to sleep lounge around. Um,
um yeah so like and plus like like i mentioned before i listen to a lot of podcasts where there's a lot of gurus like sharing their knowledge every week so comparing to these people i'm always like oh i feel so underqualified yeah what is so um in every field you have these you know recognized experts and stuff like that right so like who qualifies to be an expert in your field what does that look like
So I feel like this is like very personal perspective, but I feel like somebody who can just, you know, quote off journal articles, say, for example, like, you know, Davis et al. 2011 did this paper on like,
blah, blah, blah. And then they saw however many like subjects and then this is what they found, blah, blah, blah. Like they memorized the journal articles. Yeah. So to me, this person is like super passionate, really knows their stuff. And that's the kind of person that I'm looking up to. So it's really, it's really the level of passion you're looking at. Yeah. Right. Yeah. Because when you say like the articles and stuff, yeah, you have to have an interest, but a lot of that is like, doesn't necessarily mean,
to the quality of care they can give, right? Just because they can regurgitate some articles that they've read
doesn't mean, you know, I don't think that's directly connected to like how good of a physiotherapist they can be, right? That's true. Yeah. Because I think physio is a lot of like people skills as well, building rapport so that this person like trust you. I'm still working on that. And yeah, I guess like, you know, just making sure that they're painless because from my point of view, if being a physio and somebody being a patient, I felt like it's only recently that I'm starting to realize that we have different goals.
Like my goal might be to get them to maybe try to like be injury free for life. Like that's my kind of philosophy and goal. But then for like that person, when they come in to see me, they're like, I just want to be pain free by this session.
or at least like get rid of their immediate pain so they're looking for the quick fix yeah is that most patients you feel i think so like i think most people like um don't come to you like they'll have these little niggly pains and then they ignore it so by the time they come to see you they're already pretty like in quite a lot of pain so they want to at least like cut down their current level of pain by as much as possible and as quickly as possible
Well, is there any such thing as a quick fix with physiotherapy? Like one session you can get rid of it? Or is it always kind of a long-term? I mean, the length of the journey can vary, but it's always a result of multiple therapy sessions and repeated good habits to kind of cure any kind of physical pain that they're going through? Or can you realistically expect results in one session? Uh,
- Again, it depends on that person's goal. So for example, like let's say if this person has like plantar fasciitis, which is pain on the bottom of the feet when they're running. So by the time they come to me, maybe they're already in like a seven out of 10 pain and they want to cut that down because it's like bothering them even when they're walking.
So obviously the quick fix is if I give them a massage, like they will feel better, right? Because like you've loosened up some soft tissue and then you built that patient report because you've had that hands-on placebo kind of effect. So they will feel a lot better. And then they trust you and they're like, oh, this is amazing. Like I'm walking out with like maybe two out of 10 pain. But then that's the quick fix. However,
most likely they're gonna like go try walking again and then their pain's gonna come back the same or even worse three days later. So because I've been so kind of focused on not letting that happen, I really want to present what actually works, which is you gotta do exercises, you can do your own massage, like you don't have to pay like a thousand kuai and then travel to come and see me for an hour for a massage when there's a really quick fix and you can just do it at home.
But some people might not like that. Like some people, I've only just come to realize that some people might actually just want to come for that social interaction. And then they want to feel like somebody's caring for them about their pain. Like they want you to listen to their pain.
Yeah. So, but then, I mean, for the long term, if you want to get rid of that pain once and for all, they have to be active and they have to be doing things. And timeframe wise, each condition is a little bit different, but generally like a minimum two months. Do you find that a lot of people...
they see you kind of as like that quick fix. Like, oh, I'll just go see you. I'll just go see Oni or I'll just go see a physiotherapist if I'm feeling pain instead of trying to do the hard work of actually building good habits to avoid the pain in the first place. Do you find that as a common theme?
where people don't really want to change what they're doing? Oh yeah, for sure. I think 90% of the people is like that. So when I was working overseas, because I was in a public health system, so especially with both UK and Australia, people don't have to pay for the health system. So really a lot of them come and then they're like...
Like they just come for a massage. So you get a lot of passive people there. However, here I'm very happy. Part of like work in Shanghai is I can be a little bit more selective about it. Like if I sense this person is very passive and they just want a massage, I'd be like, oh, you know, like my colleague is great. Go and see them.
Or like, you know, I try to preach what's important. And then obviously, like, we don't develop a report because we're looking for different things. And then they end up coming back. So that's one good thing about, I guess, the private system and working in Shanghai. Because I can be a little bit selective about who I want to see as well. So what kind of patients...
come to you these days? Like what kind of categories and what are they looking for other than the quick fix folks?
So the category, most of them will be doing exercises to some level. Even the ones who are not exercising, they'll probably be thinking that, okay, like this problem probably can't be solved by me just getting some passive treatment. Like it probably needs to be active or people who come to ask me, what can I do? Like what can they do to help themselves? Yeah.
And then they'll love what I'm doing with them because that's exactly what I'm providing for them. Have these folks seen a physio before? And so they know kind of a little bit about what you could do for them? Or are they sort of new and they're experiencing physio for the first time through you? A little bit of both. Yeah. Well, how many of them are... Do you treat a lot of athletes? I do. How many...
So like you have the ex-Olympians, right? Like what kind of sports, Olympic sports were they doing? So I had one who was doing rowing. Okay. Yeah. And powerlifting. Wow. Yeah. And then you do, you treat like, I saw in your bio treat like qigong champions. Yeah. So what is qigong?
Qi gong, good question. So it's like a really slow, it's yang shen qi gong. So it's like a super slow movement. And then which requires a lot of like control of your muscles. So they need to do like a lot of squats and they're looking out for like the quality of the movement. So when you're squatting and then bending yourself over, like how well are you maintaining the form?
and how well are you going down with the spine, like segment by segment, things like that, and how beautiful your movement is.
So a lot of emphasis on the form and technique, right? Yeah, yeah. So for that particular person, she's been having a lot of back pain issues and knee pain issues. So at that time when she came to see me, she was having so much back pain because of a disc herniation. The doctors were suggesting surgery, but she didn't want to do it because it's going to impact on how quickly she can return to sports.
So that's why she came to see me. And then like, she's super active, right? Like sports and exercises, like her life. So she's really like took on this kind of philosophy where she needs to be doing whatever to help herself to get better.
Before you mentioned like passive and active treatment, what's the difference between, what's an example of a passive treatment and active treatment? So passive is what the therapists are doing for you to get better. So for example, like massages, manipulations, like acupuncture,
And then modalities like the TENS machine or the interferential laser therapy, things like that. Laser therapy? What's laser therapy? Laser therapy is like a laser beam. And then the heat that it creates, it helps to, I guess, stimulate some of the cells and then it helps to improve the circulation.
Oh wow. So it gets like deeper into the tissue, into the muscle. Yeah. Yeah. And then you can change the frequency to decide like how deep you want it to go. Yeah. Is that common now for, for a lot of athletes to use laser therapy? Uh,
very uncommon to be honest like it's more um depending on where you come from so in china because um therapy is very much um passive at the moment so they do a lot of laser stuff in china whereas in australia like i've never even heard of laser before i've came here so in your in your own practice um and experience like how much do you balance like the um
Like the scientific research in the community that's been reported and there's articles and a lot of information you can go to from others. And kind of creating your own philosophy and your own techniques from what you found to work for you.
So I still try to base my practice into as much scientific evidence-based as possible because I think that's going to be the stuff that's going to actually work and be working in the long term because I like working with athletes. So I really enjoy prolonging their kind of sporting life. I don't want them to have to stop exercising anymore.
because of this injury. And I don't want them to have the mentality that, okay, like, you know, I've got bad knees, so I should protect it. And my sporting career is over. However, there is this other population that I like to reach out to, who is the more kind of sedentary, more passive based person
I would like to kind of preach to them that actually, you know, like if you just be a little bit active with some of the stuff that you're doing, you can have like a better life than what you have now. For example, like the office workers who are at the computer like 10 hours a day, a lot of them come with like pain
20 out of 30 days or more like neck pain or back pain and some of them will even have like secondary symptoms like they'll have headaches dizziness or like shooting pain kind of radiating pain and they think it's part of like normal life like I think in China the word 亚健康 is very common so I actually had somebody saying to me that what does that mean? 亚健康 is like suboptimal health
So I had somebody who commented to me that it's like everybody has suboptimal health in China nowadays that, you know, I'm just trying to fit in by not being like super healthy. Really? So that's people actually have that mentality. Yeah. So I was really shocked by that. I'm like, really? Like you prefer to fit in just to and be unhealthy? That's really interesting. Like.
So with this, you know, the whole COVID thing going on, a lot of people are working from home. You know, they might not have as ergonomic setups in their own home. And then even globally, there's more and more people working at home. So what's your perspective on sort of this, you know, potential trend or change where people would be working in different types of locations remotely? And how does that, what are the implications, I guess, for physio and some of the work that you do?
So going back to work in March, I was kind of expecting a lot of people to come through with like neck and back pain because I'm expecting the home office setup to be really horrible. And it turned out to be half true. So half the people were because they were lounging at home and not doing any work, they feel a lot better. And then there's the other half.
Seriously, I've got people who tell me they lie in the sofa like eight hours a day.
Well, were these people that were super active before the virus hit? So like they're getting kind of like time to like rest their body and recover? No, they're the ones who were like pretty sedentary to begin with. So and then they like now that they can't go out, they're like lounging on the sofa or lounging on the bed like 10 hours a day. So it's like less of a shock to their system because they were already sedentary. Yeah.
Yeah. Whereas like the really active people before, now they have, like maybe they're like indoors, they're taking it not as well. Uh, surprisingly, they're taking it pretty well because there's a lot of like, um, workouts that you can do at home as well. Mm.
Yeah. But the ones that's lounging at home like 10 hours a day, they're coming back to work and be like, oh, I'm super uncomfortable because I got to go back to work again. And because all their muscles have atrophied from lying in bed all day, they're even more uncomfortable than before. So that's why they're coming back to see or they're coming to see physio because I've got a lot of new patients who's like never been to us before. Suddenly needing therapy. Yeah.
So in China, like what's the trends that you see in China in terms of
you know, people being sedentary or not sedentary. Like, are you seeing any interesting trends and do you have any advice? Hopefully like our, in our show, we talk a lot about self-improvement. We talk a lot about fitness and we've got, you know, we've got a lot of different fitness people, but I'm sure there are some people for whatever reason that are a little bit sedentary. What do you see in China in terms of the trend of just people these days? And do you have any advice for people who are sedentary?
I think they're getting a little bit better. So they're not as sedentary as they used to be. I do still see like maybe 80 to 90% of the population like super sedentary. 80 to 90%. I think so. Really? Yeah. And now I have people who are telling me that they work out regularly and now I'm like, okay, sure. So what's regularly? And then they'll go like attend like a class like once a week and they think they're super fit.
But it's also like what they define as a workout too. I've talked to a lot of people and they're like, oh, I work out. You know, like, oh, I had a really tough workout today. And these are not people that were really working out before. I'm like, oh, cool. That's great. Like, what did you do? And they're like, yeah. I took the subway. No, they're like, oh, I ran on the treadmill for 15 minutes. I'm like, okay. And then like I see them on the treadmill and they're just like walking for 15 minutes on the treadmill. And like that's a workout for them. Yeah.
Yeah. So I think as Eric would know, I get pretty pedantic and pretty specific about my questions when I do see a patient. So for example, I'll ask, do you work out? What do you do? Like if they tell me running, okay, how many times a week do you run? What's your pace? Like how long do you run? Show me.
right now seriously run with me right now no no no seriously she she will take the any of her patients and like you have to go to the treadmill and you have to run yeah and it's not for like two minutes it's like 45 minutes but it's necessary right because everyone has their own standards of like what a workout what qualifies as a workout yeah and what qualifies as regular yeah so just as an example like um
Most of the males who work out a lot, if you break down their workout, they will never stretch and they hardly work out their lower body. So, okay. So let's get into some like myth busting here with you, right? Like in terms of stretching, like before a very like any like duration of like active activity, like intense activity, whether it's a workout or a sport, it's better to stretch before or after? Yeah.
Both. So there's no clear scientific evidence showing that stretching does anything. So for example, some people say that if they stretch after a workout, they'd feel less sore the next day. So there's no evidence to prove that's actually the case. Really? There's no data? Insufficient data. Really? Yeah. And then in terms of stretching for like increasing flexibility and increasing like...
kind of preventing injury, again, there's no like concrete evidence showing that that's actually the case.
but we still stretch because it feels good. So personally, I still recommend stretching before and after. So before, probably more of a dynamic stretch, which helps to warm up the muscles as well. And then after, probably more like a static stretch. Yeah. So for those that aren't aware, can you explain dynamic and static? Dynamic stretching is involved in actual movement movements.
Right. So you're moving while you're stretching, you're like kind of bouncing. So it's not like a static stretch is like where you stretch and hold. Right. Yeah, exactly. Okay. So basically, you know, because I'm not in the field of physiotherapy, I'm very much an average Joe, you know, kind of guy working out. And, you know, in my mind,
I think it's pretty unanimous that everyone thinks stretching after a workout is beneficial. But I found talking to a lot of people, there is a divide in the mentality of like, should I stretch before a workout? Some people think like if I'm loosening up my muscles before a workout, I'm actually more prone to injury.
But then, you know, some people don't believe that. So like you believe that stretching before a workout is the right thing as long as it's dynamic stretching? Yes, that's the short answer. So for example, I've actually had this discussion with –
one of my patients who works out like five times a week like for an hour each so and he's quite a kind of kettlebell guru so he's saying that uh he never stretched before a workout or actually a lot of personal trainers will do that too because um then they feel like uh that the muscle cannot exert as much power and they feel like they're more prone to injuries so
So it's true that you can exert maybe less power after you're stretched out. However, from a rehab point of view and from an injury prevention kind of view, if your muscle is tight, so muscle fibers, so this is getting a little bit scientific. No, no, no. So muscle fibers, they can contract and they can lengthen. So if it's already...
If it's in like a non-warmed up state, let's just say the muscle is like four centimeters long. And then if you...
continue to kind of strengthen and contract in that length, you're only ever going to be working out in that four centimeter span. However, if the muscle's full capability is actually six centimeters, you want that full capability. And then that end of range kind of muscle contraction is where people are the weakest in, which is why they feel like they can't exert as much force once they've stretched out. But actually, you do want to kind of strengthen in that full length rather than just whatever's short. Yeah.
And in order to strengthen and work on that, those ranges where you're not usually exercising is to stretch. Yeah. Right? So what are elite athletes? So like the elite athletes that you work with, what do they do? Like given that there's not, you know, conclusive scientific evidence, for the elite athletes, what's the best practice for them in terms of stretching? Again, they will stretch before and after. So more of a dynamic exercise.
uh flow stretching uh probably some people don't even consider it a stretch but something to warm up the body and make sure that you're as flexible as you can be uh and then the actual workout and then um like more static or possibly gentle like dynamic stretching again afterwards so what are some examples of dynamic stretching that they do beforehand is it kind of like um like high knees like slow like bounce like skipping and like lifting up the knees kind of like
back and forth or... So for example, if you want to stretch out, let's say the back, the lower back, you can just, you can bend forwards and you can just hold it there to stretch your back. But if you want to turn more dynamic, like you can go through like a cat and cow flow where you're going through kind of contraction and lengthening throughout the exercise to slowly kind of stretch it out more and more. Or you can go like, or you can hold it into a child's pose and
And just keep it there. Or you can go child's pose and then coming back the other way, child's pose, coming back the other way. But if you keep it there, then that's static stretching? Yeah. Okay. But you're saying before the workout, it should really be dynamic stretching, right? It doesn't have to be, but it'll feel more comfortable that way. Well, what about in a context of performance? So, for instance, in gymnastics, you kind of have to be flexible because you won't be able to execute correctly.
you know, certain kind of moves, but let's say that you're running, what are some common things like maybe running, um, you know, some type of boxing, um, you know, uh, maybe Spartan, that kind of stuff. So what's the role of stretching in terms of just being able to perform, um,
the actual motions. Is there a rule? Kind of. So again, if it's just dynamic stretching, so if you're not warmed up and you head straight into exercise, like your muscle is not reaching its potential. So you're more likely to again, injure yourself and you probably can't exert as much power.
But however, once you're nice and flexible and stretchy and you can use the full length of that muscle, you're possibly also getting a better and a stronger contraction that way. So again, it goes back to that range of motion, the range of contraction. Yep. Okay. So like going back to some other myths, okay? Another big one is for runners, right?
Now, I've heard two schools of thought in terms of just general impact sports in general. Something like running, long distance running, is that it's not good for your knees, that it deteriorates the knees because there's obviously this constant impact when you're running on the ground, especially on pavement and hard surfaces.
But then I've heard another school of thought that says that the more regular you do it, your knees and joints build up like strength from it. So it's actually helping the joints.
especially the knees. What's your perspective on it? So there are some recent emerging evidence. It's a longitudinal study, which means that they followed a group of non-runners and followed a group of runners and then to see kind of the state of their knees.
and then follow them up for 10 years. So what they found is actually the kind of degenerative changes, which is commonly known as wear and tear, it's less in runners compared to non-runners. - Really? - Yes. - Yeah. - Wow. So where was this study done? - I can't remember, sorry. I'm not one of those gurus who can quote off all these things. - But is this a new study?
Relatively, yeah. So new as in like within the past decade. Wow. Yeah. So do you know how many people they studied in this? I can't remember. But a bunch of people I would have to say. A lot of people, yeah. So normally if it was a study that was like 20, 30 people, we'll be like, no.
might not be enough of a sample size for us to say this is a really reliable study but that was one of the biggest studies where they at least followed up a few hundred people and over a course of a decade too which is important so they found the people who ran regularly and this is long distance running I'm assuming how do you classify runner versus non-runner uh
So runner as in like they just run. So they won't be very specific about how like what's the distance to be considered as long distance running. So there are two kind of mechanisms behind that. So number one, if you run regularly, you're keeping your muscles in shape. So you've got better muscle tone and better muscle flexibility when you're running. And the other thing is as you're using the joint, so our brain is very, it can be very
You can think of it as very lazy. So if I'm constantly using that joint, then it's thinking, okay, I need to use this joint. So let's build more bone density as well. However, if you don't ever use that joint, the brain thinks that, oh, I don't use this joint. Let's put less bone density there. So it actually helps to kind of maintain the bone health as well as the muscle health if you do put a little bit of weight bearing through it.
So, okay. So one of your goals that you said earlier was to help people be injury free for life. And then you also alluded to the kind of like helping athletes prolong their career and stuff like that. So would you recommend like running to everyone given that a fundamental condition for being a human being, the quality of life is to be able to move?
and walk around and stuff like that. So, like, would running be on the top of... one of the things on the top of your list for activities or are there other ones that you would recommend? So, no. I wouldn't recommend running to everybody. Reason because I, like...
In terms of movement, I think the more variety, the better. So number one, because running is so repetitive, there are like, yes, so the study shows that they actually have better joint health if you do run. However, like I said, they won't, I can't remember if they were very specific about how long they actually run. So actually the super long distance runners, especially if your body is not built for that sport,
you probably will injure yourself as well. So I don't like to recommend people to be into one sport. I like to recommend people to have a variety, as much of a variety as possible. Yeah, I would have to assume that with running, I can see how running can increase your joint health and overall at a...
a balanced amount of running, I guess. But there's gotta be a point where you're running and if you're running for too long, too often, it's gotta be adverse to the health, right? There's gotta be a point where it starts declining. Yeah, so I think this is kind of like nutrition as well. So you know how, say, for example, if people say like,
like goji berries are good for you. It doesn't mean you go ahead and start eating like a kilo of goji berries every day because goji berries actually contain a lot of fructose, a lot of sugar. So if you're going to eat that much, you might end up with diabetes. So I think like everything like, you know, in moderation. What is the real health benefits of goji berries? Because I hear that a lot, but I don't really know what the actual health benefits are. I don't even know what goji berries are.
People put them in their tea and stuff. It's anti-oxidizing. And I think it's good for like immune health. Because, you know, with the pandemic going on, I've got a friend who's really into this kind of health stuff. She was asking me to take like a whole handful of goji berry tea every day.
So between running and swimming, right? Because especially I think a lot of the older generation, like my parents, right? My parents are like, you know, don't run, you know, because like I'm like overweight. And so they're like, you know, don't run. You're too heavy to run. You know, you should swim, you know, swim because it doesn't put impact on your muscles and it's a full body workout and you get to like kind of float in the water and, you know, it's still a great workout, but you're not really putting any impact. Is there a lot of truth in that?
Yes and no. So again, our body needs that little bit of impact because your body needs the impact to build the muscle strength as well as build the bone density. So for example, like there's a lot of evidence behind osteoporosis. So women after menopause are very prone to getting osteoporosis. So all the exercise that's proven to work to slow down osteoporosis are weight-bearing exercises.
So you have to use that joint for bone to build in that joint. What do you do? So what kind of stuff do you normally do? I try to vary as much as I can. So like on Mondays, I'll play badminton. On Tuesdays, I'm trying to do a little bit of yoga. So more stretching based. On Wednesday, I try to go for a run.
On Thursdays, I do personal training. So more strength-based workout. Fridays, trying to do a bit of yoga again. So I'm actually like super tight. Like nobody believes that a girl can be this tight until I show them. Yeah, I'm really, really tight. And this is like genetics. Like I'm just born this tight. So I hate yoga because it's so hard for me, but I do try to do it.
Saturdays, I try to go for a run. And then Sundays, try to go like join like a workout group. What kind of yoga do you do? Is it like the Bikram, like heat yoga, like hot yoga or just normal? Mainly just like yin yu jia. So like the kind of static stretching based. Okay.
So you work out seven days a week? Five to seven. Wow. Yeah. So it's pretty clear your philosophy, like, you know, we've had nutritionists on the show before and their philosophy was like, look, there's no magic diet. There's no magic program. It's about balance. Yeah. Right. And that's kind of your same philosophy when it comes to keeping your body healthy. Physiotherapy is like, you know, a balanced variety of
of different activities to kind of keep that range of movement, keep your body like constantly on its toes so it doesn't get too repetitive and you don't get like too static in terms of like one particular routine, right? - Yeah, and then try to exercise probably all parts of your body because if you only run, it's, I mean, mostly lower leg based
So you never get an upper body workout. And if you only ever do yoga, a lot of it is like kind of isometric contractions of the muscles. So the muscle never ends up getting through the ranges of motion. Plus it's a lot of like stretching base. So for someone who's already hypermobile, meaning that they're too flexible, they might love yoga because they're so good at it, but it's not necessarily what actually their body needs.
So for people out there who might not be really realistic for them to constantly be doing all these different kinds of activities all the time and switching it up all the time, like if you had to pick one activity to do for the rest of your life, and you can only do this one activity for the rest of your life, what would you choose? That's hard. Is this for myself or for somebody else? For yourself. For myself. Yeah.
- For now, probably badminton because I actually hate like, sorry, like I hate doing like exercise. I love doing sport.
So growing up, I used to play basketball. So I love the kind of team dynamics. I love the a little bit of the competitiveness and then just the social interactions with sports, which you don't get if you're just like pumping iron in the gym. If you're just like doing a stretch in yoga. So so if you were recommending for someone else purely for the sake of longevity and health.
What would you recommend them to do? If they can only choose one activity. Oh, that's too hard. Gun to your head. You can only choose one. Oh, gosh. I don't know. That doesn't... That's not part of like...
That's disagreeable with my philosophy though. I know, I know. That's why I'm asking. Because I think variety is important. Yeah. So maybe like kind of HIIT workouts because it's a balance of like cardio and strength-based. Okay. Plus like, you know, you have your stretching before and after.
Okay. So I have a kind of a non-sequitur question. So you played basketball growing up. Who's your favorite basketball star? Right now, I really like Steve Curry. You mean Steph Curry? Steph Curry. You don't watch a lot of basketball. I don't know who Steve is. Steve? No one in the history of the world has ever called him Steve Curry. You mean Lebron James? Lebron James? James?
This is literally the first time anyone's ever called Steph Curry Steve Curry. Steve. Stephen Curry. Steve. My name is Steve. This is the first time that's ever been said. Okay. Why do you like Steve Curry? I like his three point. I like his three pointers.
Why is three points good? I don't know. I just like it. And then plus, I think he's had so many ankle injuries, but he keeps bouncing back again and again and again. Yeah, so that's pretty amazing. Because as a basketballer, you need a lot of ankle stability. So I'm pretty sure... I mean, I don't follow his rehab process, but I'm pretty sure he's doing an amazing job with it. Well, if you were Steve Curry's therapist...
Knowing that he has chronic issues with his ankles, what kind of a program would you run him through?
I mean, it's always the same, right? So you've got to have enough strength to be able to do some of your balance or proprioception work. Yeah. So it always involves strengthening plus a lot of proprioception work. So I don't know if you've seen that. Pro what? Proprioception. So proprioception is your body's awareness in space. So you should be able – I mean, the kind of easier way to understand is just balance. Okay.
Why did you just say balance? I'm used to saying per perception. Well, I did read about like Steve Curry, Steph Curry, and he can bench like, you know, 400 pounds and like his, he is strong. He's like crazy strong. And the way that they trained him, because there was some articles a couple of years ago, because he was very prone to injury at Davidson. And then his first couple of years in the league, he,
And so the way they trained him and his agility and everything, it was, it really was all about strength so that whenever he was making his moves, because he's so agile and so quick, um,
They had to strengthen all kinds of different muscles. And then also, I think they gave him some type of support in terms of the shoes and some of the other equipment. How do you know so much about Steph Curry, man? Yeah. All of a sudden. Yeah, I got ankle problems too. I think at the end of the day, strengthening is actually super important. And a lot of people don't realize that because like...
you gotta have strength as a foundation for everything. Like you can't have good balance without strength and you can't move well without strength. - Well, I think that's where a lot of misunderstanding comes from, right? Especially for people because like when you say strength, they're like, okay, I'm gonna do some squats. I'm gonna do some pushups. You know, I'm gonna do some bench presses.
rows, but like a lot of the strength you're talking about is related to joint strength. And that, that depends on a lot of the smaller muscle groups, right? Not, not a lot of the major muscle groups, right? Yeah. So that's so true. So, um, I mean, I have a few patients who, well, actually I have a lot of patients who, um, they go to the gym maybe like six days a week and they're pumping iron just constantly. And they really build muscle.
they come to see me and tell me for example they have shoulder problems so
It's really easy to see why because they're focused so much on doing like the big muscle group exercises, like the bench presses, the pull-ups, kind of the raises. The vanity muscles, right? Yeah, so whatever looks good and that they never work on the smaller muscles. So for example, I've got a patient right now who has left shoulder pain, very, very good body, like six pack, everything. However, when I asked them to do one small muscle group,
like just one minute of this super simple exercise on the left side which is the injured side they feel like a 7 out of 10 fatigue from just doing one minute of it whereas on the right side they feel absolutely nothing so it really is like that attention to like a lot of like that
those stabilizer muscles, right? I hear that term a lot. It's like the stabilizer muscles, especially with the shoulder, a lot of like the rotator cuff. It's like a lot of the smaller muscle groups that the rotator cuff is surrounded by. Yep, yep. So you can imagine your muscles like an onion. So you've got the outer layers, which is the bigger muscle groups, and that's for around power. And then you've got, you peel away the outside layers, you've got the smaller muscles, which
which is more for posture and stability and control. And I view them as like the foundation of a building. If you don't have a good foundation and you're trying to build a building, it's very unstable. That's a really good analogy. The onion one too. Like the outside are like the major muscle groups, the ones that are typically easy to work out.
but then you peel away in the layer and then you're surrounded by all the like the smaller muscle groups the ones that you don't even know are there right so that's why sometimes when you go see a physiotherapist like you and you ask them to do certain moves that are really simple but moves that they don't really necessarily do too often all of a sudden like the next day they feel like really sore and they're the biggest working out like muscles they've never even probably used before yeah and
And what people don't realize is sometimes they get injured or their big muscle groups get really sore. So, for example, something very common is the upper traps. So a lot of kind of like people who like to go to the gym, they have a lot of upper trap soreness. What they don't realize is that why is the upper trap sore? Like they got to think about it. Is it overworking because it's trying to work for the smaller muscles that's not working? Mm-hmm.
So if they have a very stable shoulder, their shoulder should be externally rotated and depressed when they're doing, for example, like a shoulder press. But when that's not happening and that's not taking any of the load that it's supposed to, then the upper traps is doing the work. So they might have tight upper traps,
because it's overworking for the rotator cuffs, which is why the massage will feel good because it's kind of releasing the tired upper traps, but it's not going to solve anything because their movement pattern is still incorrect. So they could feel better, go back to the gym, and then the same problem is going to come back again. So with massage therapy, massage therapy is always just really a quick fix. It can never really...
get to the underlying root problems of injury and pain? I don't think of it as a quick fix. I think of it as part of the treatment and it's a necessary part of the treatment. Because for example, if your upper traps is already too tight, I don't know if you've seen anyone with like say shoulder one high and then the other. So the higher shoulder, it could be possibly from the upper traps being so tight that it's pulling the shoulder up.
So when that's the case, you have to do manual therapy to loosen up that upper traps for that shoulder to go down because otherwise it's starting off in the wrong position. And then whenever you try to move, it's wrong throughout because it wasn't correct to start off with. So what's your view on like massages, stretching versus like foam rollers, right? Foam rollers are very popular now. Everyone's using foam rollers now.
Is that just pretty much the same thing as stretching or is that a better way to stretch?
It depends. So for example, so if they have a tendon problem, now like within the recent decade, what's been found is that tendons, especially insertional tendinopathy, so where the tendon attaches onto the bone, they found that it usually happens because of either a compressive force or stretching force. So in that case,
I shouldn't be recommending stretching because if it's, uh, if it's inflamed from too much stretching, too much pulling and you're stretching even more, then it's going to make it worse. So don't stretch if they have like an insertional tendinopathy. However, uh, if, uh, so in that case, I'll recommend foam rolling. Okay. Yeah. But that's a very specific case, right? It's a very, so, uh,
So, I mean, if you're injury free, then do whatever you want. Like you can stretch, you can foam roll, you can use a Theragun. So like kind of the... Yeah, like that hammer, that jackhammer, like massage thing. Yeah. So that's quite popular nowadays as well. Yeah, yeah. It can get very expensive. Yeah.
But if you're injury, if you're injured, which from my point of view, which is normally what I see, I would recommend either stretching or foam rolling depending on the condition. - So you don't see any clear advantage or disadvantage between stretching or foam rolling? - Not really, because there's not enough evidence behind any of that. For example, with foam rolling, so that's like you using something external to press on our muscles.
to supposedly make a change to the fascia or to the muscle. However, there's evidence showing that you need so many newtons of force to be able to make that change that it's impossible to do with a foam roller. Well, what about with that massage gun we're talking about? They say that can get a lot deeper, right? Because it's a lot more powerful. Same thing, like not powerful enough. Really? Yeah. Even that? Yeah. So the massage gun feels really good. So is there any...
connection between something feeling good on your body and releasing the
some of the stress and the damage? Yeah. So some people will say physio is like 50% or maybe 80% placebo. So that massage where you're building the report, so they even have like a frequency for how quickly you should be massaging. So if you're going at like, I can't remember the rate, but it's almost like that two...
two movement per second kind of rate, they've shown that that movement is the most comforting.
for trying to calm somebody down. - You mean like that? - Yeah. - Go harder. - But two per second. - I know it feels so good, right? - Feels good, Eric. - Yeah, that part. - Oh, that feels good, Eric. - So, and then part of making that person feel good and if they believe in what you're doing because they're like, oh, this person knows what they're doing because I'm feeling better from doing it. Part of it in the brain, psychological, that's what's gonna work.
So what's your view on a lot of the holistic approaches to therapy when it comes to physical and the body? I think it's probably a mix like half and half.
Yeah. So there are evidence behind a lot of things and there's not enough evidence also behind a lot of things. Yeah. So if you listen to, if you read the journal articles and if you listen to the physio podcast, you'll find that a lot of things are inconclusive. So sometimes I'm questioning like, why am I even in this field? Because half the things is like not even proven. Like half the things just seem placebo. Yeah. So, okay. To that point, yeah.
part of what you do is remove barriers for people that want to do exercise or do sport, right? So from your perspective, what's the value of exercising and doing sport? - I think so, for example, if you're doing exercises and your weight bearing is preventing osteoporosis,
I mean, I know it's some bone-related stuff, but what is it? Osteoporosis is where the bone density is reducing. So normally our bone, you can imagine it as a solid, so like a block, like a brick. However, with osteoporosis, your brick is becoming spongy because whatever... There's like holes and like, right? Yeah. Brittle. Yeah, brittle. So with osteoporosis, you're more likely to break the bone because it's not solid and it's not filled. Right.
Yeah. So exercising wise, that's a good thing for it. For the heart, our heart is also a muscle. So if you're doing cardio exercises, that's exercising the heart. So for example, like I actually recently went to see my colleague who's a cardiologist because I was, ever since I got the Apple Watch, I'm like, oh, my heart rate is like, like,
kind of abnormally high. Like if I do like a run, my heart rate will be at 190. But if I see other people's heart rate, it's at 150. So I went to see her and then she did an echo and then she found that my heart is smaller than the average size. So then it has to pump harder to be able to meet the, however hard I am working. So through exercise, I can actually make my heart bigger.
Which is one of the reasons why I'm doing a little bit more kind of cardio-based workout for that reason. So, it's not because I enjoy cardio. I hate it because like it's very hard for me. It's tough. I feel like I'm dying because my heart is working so much harder. Me too. However, like if you keep doing it, your heart can get bigger because it's a muscle and then you'll feel like it's less effortful. So,
So this is like purely like I do cardio from a quality of life perspective. Like I would like to be able to walk up the stairs without like panting, which is usually the case. Yeah. Have you read any research on like cannabis and like CBD oils in terms of its effect on joint health and pain relief?
I haven't read any research on it, but just I've got friends who's tried, I think, marijuana rub before. And then I think it's pretty helpful because it's like a topical kind of pain relieving thing. Well, a lot of people like CBD is getting very, very popular now, right? Because CBD kind of eliminates all the psychoactive elements of marijuana. Yeah.
But like I've been reading, you know, I don't know, but I've been reading a lot of, you know, a lot of athletes are starting to use like CBD, like pills and things like that. And they say they really feel, so I don't know.
I don't know if that's like something that's emerging in your field, if that's something that's been talked about more and more. - Not as much because it depends on the country as well. I don't think it's legal in like every single country just so far. - No. - Yeah. - China is the biggest producer of CBD though currently. - Really? - Yeah, in the world. - I don't think it's legal here though. - It's interesting though. - It's not legal here, but they're the biggest producer. - If it takes out that psychoactive stuff, right? - Yeah. - It seems like it'd be pretty dope. - Like you can't get high on CBD. - That's awesome.
I don't know. So one last question about like joint health, because this is just for my, because I'm like, while you're here, I'm trying to like debunk every like, or like get to the bottom of like every. You should charge him. Everything I've been told, you know, growing up. And we know one thing is like lifting weights. If you're still developing as a kid, you know, you're not fully matured yet. Like let's say you're in your early teens and,
You know, a lot of people say like you should not lift weights. It might stunt your growth. Do you believe that? Again, like I try to base my beliefs on scientific evidence. I haven't seen anything about it. However, like your bones do grow quicker than your muscles as you're growing. So you'll have spurts of bone growth and then followed by muscle growth. So I don't know if you've heard of like growing pain before.
Growing pain happens because your bones has grown quicker than the muscle. And because the muscle hasn't stretched out enough, because of all that kind of stretching, it feels really uncomfortable. So again, if you go back, like if you do a lot of weight lifting and then that's all like contraction, contraction, contraction, it could possibly like, you know, stun your muscle growth a little bit. So maybe the kids should do yoga.
Again, probably a variety. Like, I mean, for kids, I highly encourage them to just go out and do a lot of sports. And they shouldn't be focusing on one sport. They should be like varying as much as possible. Yeah, when I was growing up, my parents were always like, oh, you know, swim, you know, like you're still developing, you want to swim because it lengthens your body. They wanted me to be taller. There's all these myths. So like, what would be...
The I mean, like our like our audience, we have, you know, athletes, regular Joes, sedentary people, et cetera, et cetera. Right. What do you think is like the biggest like the pub, like the public enemy number one in terms of the stuff that you do with like keeping people's bodies healthy?
Posture. So I think what people don't realize... Me and Justin just... Yeah, I just sat up. I got my side up. I just pulled my shoulders back a little bit. Let me move my microphone real quick. Oh, damn. It's like five feet higher. What were you saying? Like...
So, I'm quite fidgety. Like, what people don't realize, I don't know if you guys heard the saying or not, that 10 bad postures is better than one good posture. What does that mean? So, like, I frequently go to, like, corporates to do kind of talks. And then a lot of them will request for posture talks and back pain and neck pain talks.
And then so I would always show them pictures of people like sitting horribly, like they'll be slouching or they'd be like almost lying down or they'd be like, you know, rested on the table. And then when I ask them, okay, does this look good or bad? And they'll always say it looks bad. However, think of your postural muscles as you've got a hundred different muscles working or like think of it as a corporate point of view. Like whenever you work, there's always a team working together.
So if you're always staying in one posture and you never move, then you're always ever using that 10 postural muscles. But there's a hundred of them. So you should be using all of them so that those 10 don't get overly fatigued.
So if you're within the hour, if you've moved through 10 bad postures, that means that you've used 100 all of your muscles because they've all worked. Then none of them will ever fatigue. Then none of them will ever get too tired from staying one posture. So they won't get tight or they won't get overworked.
Okay, so to break that down, you're saying to constantly change your posture and work different muscles that are holding that posture, right?
Is better than trying to maintain one posture that you think is like the proper posture. Yes. So there's no one good posture if you're going to stay in it for 10 hours or 12 hours a day. Wow. Wow. That makes me feel so much better. Yeah. Okay. Have you noticed anything bad about like my posture sitting here while we've had this conversation? Any glaring issues? So not you personally, but this is a general comment.
So for example, like you can move through 10. So this is very, very common for people with neck pain. Because if you think about it, when do you ever exercise your neck? Like nowadays, when do you ever look side to side at people around you? When do you ever look up to the sky to see, you know, how many stars or things like that? And when do you ever look down to the ground? So we all... I look down on the ground all the time to see if there's like dog shit. Yeah.
But in general, like, you know, you move every other part of your body, but you hardly ever move your neck. So you could be moving from one bad posture to another bad posture, but your neck is still not moving. So that's when people don't realize that simple things like shoulder shrugs during circles with the shoulder or just moving the head around, it's very good for kind of preventing few of your muscles in the neck from overworking. Mm-hmm.
I have to believe in like, well, like a lot of like the common neck pain and shoulder pain comes from, you know, everyone knows this. It's like, you know, sitting at work in front of the computer, you know, for hours on end, right? Like what kind of like is what they say is to like, you know, just get up and move around a little bit. And that's probably the best way to...
Do you handle that? I ask a lot of people with neck pain. I'm like, do you get up often to move around? They say, yeah. I get up, go get water or go to the bathroom. I'm like, but yeah, but that's moving your feet. Are you moving your neck when you're doing that? So you actually got to stop and draw circles with your shoulders and you actually got to stop and look around, look up and down, tilt your head side to side to actually move different parts of your neck because going to the bathroom, you're not exercising your neck.
So that's public enemy number one is posture, you say. So what about when you go to a gym? What are the biggest common mistakes you see people making at the gym typically when it comes to health, like body health, joint health, muscle health?
Um, probably the biggest thing, especially with, um, like those really built people, I think, um, like I find them trying to achieve too many sets too quickly and trying to achieve, um, like too much power, um, to the point where the form is off. So for example, like if they're doing a deadlift or a squat and then they're aiming for 150
50 kilograms to the point where they're not activating their core enough they're not activating their glutes enough and they end up injuring their back yeah so when i do personal training and whenever my personal trainer trying to increase the weight i'll always tell them okay i feel fine i think i can try to increase it or no no i think that's enough like i will never try to increase the weight for the sake of increasing the weight if my form is going to be off mm-hmm
And what's your view on like people aging? You know, as, as, as like we're approaching like mid, midlife and getting, getting a little older, right? Like, do you think it's, it's healthy or we should keep sustain, sustaining like a lot of the activity we did when we were young, even if they're like high impact activities, things like that, you know, like, like, should I still be like playing touch football or should I, should I still be like going out and boxing and sparring as
As I'm getting older, like, let's say, like into my 40s. Probably depends on your body type as well. I mean, if you look at the actual Olympians or like the pro athletes, how did they get up there? Like, it's because they were born naturally to have this really good body type where they're
highly unlikely to get injured or they're highly likely to get injured so for people who want to stay active throughout their life if for example for myself like if I'm really passionate about badminton at one point I got to realize okay my flexibility is limiting me then I if I want to keep playing badminton then I have to stretch a little bit more
Or for some people where their joints are just really hypermobile, then if they want to continue with, say, their exercises, then they've got to do strength training. So they've got to know their body type really well
and whether it's susceptible to injury or whether it's a type that doesn't get injured very often. And they just got to come into terms that maybe they need to be doing this thing to be able to continue with whatever they want to be doing. So just more preparation and maintenance. Yeah. So how do you know, like, how do you get to know your body type? So I
I mean, there's a few like, say, for example, there's like the Baton's scoring in term for hypermobility. So I think hypermobility is a big thing. So if you can hyperextend your elbows, so if you straighten out your elbows and they can bend down more than just being straight, that's hypermobile. Are we hypermobile? Nope, none of you guys are.
And then there are people who stand and they can see their knees and then it looks like it's in a bent shape. It's not straight. So again, they're likely to be hypermobile. What about my thumb? Like I see my thumb can arch back.
Right there. That's a little bit of hypermobility there. So people with hypermobile thumbs, they're more likely to get tendonitis or osteoarthritis of the thumb. More likely? More likely. And I got a surgery here before. Oh, there you go. Why don't you tell them about that story? Yeah. Well, yeah. Me and Justin were fighting. Not each other.
There you go. So, like if you use your phone a lot or if you're like carrying a lot of heavy things, needing your thumb and you're hypermobile, you're very likely to injure it. So, actually in my clinic, I feel like 80% of the people that I see are hypermobile. So, that kind of body type is very prone to injuries. So, if people are interested, they can go up and look up the Baten score. How do you spell that? B-E-I-T-E-N.
G-H-T-O-N. Okay. Let's pronounce Stephen Curry. Steve. Steve. We're never going to let that go, Annie. We're never going to let that go. Yeah. So like that's a score to kind of, if you're scoring from memory, like seven out of nine or more, then you're hypermobile. Yeah. So things like without warming up with your knee straight, can you bend down and touch your fingers to the floor? So some people...
they can touch their fingers to the floor and they're telling me that they're very tight because everybody else in the gym in the yoga class can touch their palm to the floor and now I show them look this is all I can do and they're like really like they don't believe it yeah so people who are hyper mobile they're very prone to injuries they need a lot of strength exercises and
Really? That's counterintuitive to me. I would think hypermobile people would be less prone to injury, right? Because they're more flexible, they can have more range of movement.
So if you think about it this way, so hypermobility is because the joints are too lax. So two bones form a joint. So when you have very tight ligaments, the joints, so the two bones only move a little bit. However, if you have very loose ligaments, then the two bones can move a lot. Hmm.
They need that stability. Where is it going to come from? It's going to come from the muscles. So those people might actually feel like their muscles are super tight because the muscle has tightened to try and give that stability. So if they stretch out, they'll immediately, like quite quickly, be able to be very, very flexible. However, that's...
not necessarily good because then the joints are hypermobile. So the only way to kind of balance that out is to have super strong muscles to be able to provide that stability. Okay. That makes sense. One, one last topic I want to get to you about is, um, like you personally, cause we've been talking about like physiotherapy and your perspectives and your expertise on the field and information like that. But, um,
Your own personal journey, what has been the biggest struggle for you in this field? - I think especially for the private practice, 'cause I've always, overseas I've always worked in a public health system where the goal is, okay, everything's gotta be scientific based. You gotta get them to try to be as actively involved in the treatment as possible.
And if they're not active, just discharge them. So that's always been my mentality. Like do what actually works or just don't come and see us. However, in the private practice setting, what's been really hard for me is that trying to, I guess, provide...
like for example, something passive for this person to build a rapport with me first so that they actually feel better when they leave and then trust that whatever that I'm gonna give them later, it's gonna work for them in the long term. So that trust and relationship. Yeah. Really? Yeah. Yeah, I would think that like, because in earlier in this episode, you were talking about like, that's one of like the kind of key foundations you have to build with your client because a lot of it, like you say, a lot of it is mental.
is that placebo effect as well. And that would, I would assume, has to heavily rely on how much you trust your physiotherapist, the relationship you have with them to build that mental side, I guess.
Yeah. So for the ones who I think they already trust me because they're coming for something with what can they do to make them feel better, those type of people, like it's possible that I've never ever touched them. I've never had any hands-on therapy because I already trust that they know that whatever I'm giving to them is going to work.
There are the other type of people who are like, oh, I'm coming here with like, say, tight neck. It feels really sore. Can you do something for me to make me feel better? Yes. So for those people, I might be very hands-on. So it might be a lot of manual therapy to make them feel better first so that they're actually going to listen to what I'm saying that's going to help them for the long term. Is that one of the hardest things is to get people to really buy in and to listen to your advice?
Or do you find most people just get really stubborn? They may be like, yeah, yeah, yeah, but then they just kind of like in one ear, out the other kind of thing. So again, I've been reflecting because, for example, I see that some people are very... Some physios, they can be very passive-based. And then I see that they're super, super busy with their workload. And then I'm like, how come...
they're so busy even though like they're just providing things that's not working in the long term so I've been reflecting on my own practice as well and that's when I realized okay you at least got to make them feel better when they walk out the door so that they're trusting what I'm going to say next to them so it's part it's part like physiotherapy part psychotherapy in a way right yeah so which is why like I used to never do manual therapy and I really suck at it
But now I would do a little bit of manual therapy if that's what's going to help this person listen to what I will say next that's actually going to help them. Yeah. Where's your clinic? Where's my clinics? So it's Sino United and there's five locations, but I'm based at the Shanghai Center location. Oh, wow. Yeah. So how long have you been based there?
- So because I've been like in and out of Shanghai, I think in total, maybe like three years. - Okay. - Yeah. - Okay. What brings you in and out of Shanghai? Like why do you keep, just make up your mind, damn it. - Again, like, I mean, my grandparents brought me here, but then I realized, okay, like at that time I was quite junior and then I felt like I wasn't happy with the work situation because I don't feel like I had somebody to learn from.
And I enjoy having like a mentor who I can learn from because I'm the type of person who don't look down on things. Like I don't compare to people who's like worse than me and I feel great about myself. Like I like to compare with people better than me and then like strive to be like them. So I was like, oh yeah, I don't, I'm not getting any learning here. So I decided to move to UK and then come back.
Okay. Do you feel the landscape's changing here where you can have people you can learn from here now? Is the field getting better or not so much yet?
uh still work in progress yeah yeah yeah so one thing that i struggle with is uh i think a lot of people like when they go to see a doctor they think age like as long as you look old you must be really professional experience you have to like look wise look the part right yeah yeah i get it and then plus being a physio working ms trying to work with athletes
For example, like, you know, the bodybuilders, like it's very hard for them to go past that mental stage. Like this young looking girl is going to help them. Yeah. Right. Especially like a buff dude who's like very like alpha or something like that. Yeah. Well, I think I think that's to be expected because in my view, like the whole fitness movement, fitness culture in general is.
is really just starting to take foot here, right, in China. And you see a lot of gyms popping up and you see more and more of the local culture kind of ingraining health and activity and working out into their daily routine, even though it's not as commonplace as it is, let's say, in the West yet, but you see that trend, you see that growth.
And what's going to follow behind that, because that needs to take place first. And then what's going to behind that is the whole kind of physiotherapy kind of movement, that community, the awareness, right? And the need for that is going to come with that fitness. So it's, I would see a very bright future in your field here in the future. I hope so. Because in general, I feel like physio in China is lacking behind everyone else by
by like at least a decade. - Yeah, well it's the awareness, right? It's the awareness and I hate to use the word education because then it sounds like they're not educated, but it's the awareness and education of like this need and this very real benefit of physiotherapy to maintain your body, to keep doing it, whether you're doing sports, whether you're a professional athlete or whether you're just aging.
- Yeah, and then the shift from being like really passive because I mean in China, like or like physio where like they're doing all these passive modalities. I have a lot of people who go there like every single day. I have patients who tell me that they were previously waking up at 5:00 AM every morning to just line up for a spot in the local hospital to try and get all these passive modalities.
And then because it's such a tiresome schedule, like they stop for a period of time and then their condition go back to what it was before. Yeah, so it's what's being provided in the public hospitals that's setting their expectations, like what physio should be like.
So, yeah, I think it's still a long way to go. And it's also a cultural thing. Like when a lot of people, they experience like neck or shoulder pain, let's say from like sitting and staring at a computer. The first thing they think is like, oh, I'm going to go do a massage. You know what I mean? I'm going to go like condo, like downstairs and get a massage or maybe even acupuncture. Right. So like the whole kind of more scientific Western physiotherapy thing.
that's not as much a part of the culture yet as just, you know, classic Chinese massages and things like that, right? Yeah. So one question that I get asked like really frequently is what's the difference between what you do and a massage?
And I struggle with answering that question. Why? Because like maybe initially I do need to do a little bit of manual therapy for them to feel better. And then they're having difficulty struggling between the difference. And then, I mean, because rehab is not very regulated in China. So you have,
personal trainers doing like ACL post-operative rehab and giving advice and you have people in like massage or facial salons doing like pelvic floor rehab or doing like um
like neck and back pain treatment and they will give these advice and then people will think like okay like you know like you're doing the same thing like you're giving me advice you're giving me a massage so what's the difference so you think there's a lot of bad information out there yeah yeah yeah well i'll come with time i think the better but oni thank you thank you for coming by great talking to you thank you it was a pleasure yeah
Give a shout out to Steve for me. Okay. Cheers. To Steve Curry. Cheers. Cheers. All right, guys. I'm Justin. I'm A. Rick. All right, guys. Peace.
Bye.