Chronic Pain: Dr. Mitchell Yass
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Guest: Dr. Mitchell Yass
Release Date: 1/23/2023
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Steve Washuta: Welcome to Trulyfit. Welcome to the Trulyfit podcast where we interview experts in fitness and health to expand our wisdom and wealth. I’m your host, Steve Washuta, co-founder of Trulyfit and author of Fitness Business 101.
On today’s episode, I interviewed Dr. Mitchell Yas, he has his doctorate in physical therapy, although he does not use that anymore, per se, at least not the education behind his physical therapy degree and the protocols in which physical therapists use. He has a different ideology in which he believes pain is misdiagnosed.
And it is I would even say, misrepresented and certainly handled improperly in the medical system. And he’s gonna go down the rabbit hole and talk about why he believes things need to change. He gives the science behind it. He gives sort of mechanistic and causal reasons behind it, right? I don’t let people come on the podcast just to spew nonsense.
He has actual mechanistic and scientific reasons why he believes that we need to change the processes now. I don’t agree with everything. Dr. Metropolia says like, he talks about things like a well-being of a nervous is trapped. If there’s some nerve entrapment, then why don’t we see pain being persistent and consistent?
Well, you know, a nerve being trapped or impinged, or movement-based, right? So in certain movements, that nerve is not going to be trapped, it’s not going to be pinched. It’s not there is it is going to be relieved, so to speak. You know, and there are some other things my wife being a sports medicine doctor, who she would have certainly a lot to say about this, and, and I’m sure maybe down the road, she will, and then I’ll have Dr. Gas on again after her episode.
And he can come back on and say what he thought was wrong on her end and what she was misrepresenting, but he does have a great sort of, I guess you would say big picture view of what’s going on in the medical industry from older people that he’s helped the process when people first have pain, to getting an MRI to getting diagnosed.
To go into the physical therapist, he has a great big-picture view of why that whole process can really be cleaned up to help people move pain-free. It was a really great conversation. If you want to learn more about what Dr. Yes does. Please go to live without pains. And that is live underscore without underscore pains. On Instagram, you can find everything there or you can go live without pains.com.
With no further ado, here is Dr. Michel Yasna. Dr. Mitchell, yes, thank you so much for joining the Trulyfit podcast, why don’t you give my listeners in the audience a little background on who you are your credentials and what you do in the health industry?
Mitchell Yass: Sure. So first, let me start by saying I have a doctorate in physical therapy. That is not to say I practice physical therapy. In fact, the method that I utilize, I derived as a result of recognizing that my medical background did not prepare me properly to diagnose and treat the cause of pain. So what I do now was a result of seeing the failure of the existing system. So that’s very important to understand.
Mitchell Yass: Basically, a rough shot of how I got here was I was very thin guy had a lot of self esteem issues, wanted to put muscle mass on from 19 to 26. I started lifting weights did everything Joe wieder and Arnold Schwarzenegger told me to do nothing worked. All of a sudden at 26. I remember I take a high school physics course.
Mitchell Yass: And I’m like, wait a second. Weightlifting has something to do with physics, because gravity is a force factor. And maybe there are aspects of physics that can actually help me lift weights. So I stopped looking at force vectors, fulcrum, moms levers, a variety of physics laws. And all of a sudden, over the next four years, I put 40 pounds of muscle on that is the basis by which I do strengthening. This is not from a curriculum.
Mitchell Yass: This is literally a self taught understanding of the laws of physics applies to weightlifting, just as that’s happening. I was a project manager construction, quit that job. All of a sudden, I hear about this thing called physical therapy, I entered the practice.
Mitchell Yass: Within a couple of weeks of entering the curriculum, I’m recognizing most of what saying is baseless from a logical standpoint. And I start to recognize that I can follow that as I’m doing my final affiliation and stop treating people.
Mitchell Yass: The big jump of logic was that as I’m training people, and I would say, Where is your pain point to where your pain is, it was not where it should be, if an identified structural abnormality from an MRI, what to create pain. So by definition, that structural variation could not be the cause of that pain.
Mitchell Yass: I went on to interpret the symptoms recognize that the cause of pain was muscular in 98% of cases and utilize that self derived strength training program to be able to make people be out of pain in a session or two. So that is kind of the crux of what I’ve come to do and know
Steve Washuta: well, that there’s a lot there to unpack but let’s let’s go with one of the one of the last things you just said you said 98% of pain is muscular, but I mean you’re saying it’s not nerve Have related. You’re saying it’s not, you know, tied interwoven with all of these other things. You’re saying. It’s really simply just muscular
Mitchell Yass: that is 100%. What I’m saying. So interesting. Let’s look at the evidence because I am a logician, and I only do things based on logic logic is to say there must be a theoretical basis for something. But most importantly, then empirical evidence, evidence that presents What is much Matchett. It can’t just be a theoretical basis.
Mitchell Yass: And follow that when empirical evidence says what you’re saying is wrong. So number one, when did chronic pain begin? Did it ever exist in the history of mankind? The answer is no. Never, ever go back. Look at it. You’ll see it began in the mid to late 1980s.
Mitchell Yass: Why? What drove chronic pain? The answer is technology, technology, automation, computers, all these type things started changing the way people live their lives, they went from doing jobs that required manual activity, to doing things with a sit and look at computers. In terms of recreational right when I was a kid, I played football when I was a kid, I after school right now that kid plays Madden football on a computer.
Mitchell Yass: And what you can see is that throughout all of culture, things went from being done manually to being done from an automated standpoint. So as a result, our muscles began to weaken, when we then did try to do things they weren’t prepared, and so they strained. So the primary reason that people have pain from the 1980s forward is because the force requirements of gravity to do activity is greater than the force output of people’s muscles.
Mitchell Yass: That’s what you saw from the 1960s and 70s. The only people really suffering from pain, were people who had retired the older and they called it rheumatism, but it really wasn’t rheumatism, it was muscular to now people from the 20s to the 90s, suffering from chronic pain.
Mitchell Yass: The reason it became chronic, not just this massive new population of people in pain was because part of that technology was the advent of the MRI, which finds structural variations, herniated discs looked right at stenosis, any of these type things, the thing that everyone better wrap their head around is that muscular causes cannot show up on MRI, or X ray. So if it is a muscular cause, the people you are seeking care from to get the proper diagnosis will never provide the proper diagnosis. Right? So
Steve Washuta: let me run through maybe a scenario in which you’re trying to describe here I am having lower back pain, I see multiple physicians, they’re not really sure what’s wrong, they sent me to a chiropractor, not sure what’s wrong, isn’t my physical therapist, not sure what’s wrong, I finally get an MRI, they say, hey, it looks like you have disc degenerative disease, you might have a little herniation or compression and, you know, whatever, you’re somewhere in your lumbar region.
And because they see the structural abnormality, they’re telling you that this is the reason why you have pain, what you’re saying is because you can’t see the muscular pain, they obviously can’t diagnose that. But really that would be the key issue in the pain.
Mitchell Yass: Right? So let’s break apart a bunch of things you’re talking about. Number one, you have this pain, right? Did you get an MRI prior to having the pain? No, you first get the MRI at the time of the pain. For the first time, the herniated disc stenosis or arthritis is identified. And since it’s identified for the first time, at the time of your pain, it is asserted to be the cause of your pain.
Mitchell Yass: Would anyone disagree? That is the basis by which the diagnosis is graded. No question. Correct? Correct. That is called correlative theory from a scientific basis. And correlative theory says that if I open my front door, when the sun rises,
Mitchell Yass: I can say opening my front door causes the sun to rise, and I can have you stand up my door for six months, and I will open my front door and you’ll see that sunrise, but I don’t think you’re going to accept that I’m causing the sun to rise, right? You would say that’s nuts.
Mitchell Yass: So clearly, why would you accept correlative theory is the basis for diagnosing you. So let me ask you this. What the MRI at the time of your lower back pain show you have two elbows? You have two elbows correct. So based on logic, I could say the MRI found you have two elbows on that picture for its first time at the time of your pain.
Mitchell Yass: Therefore I will assert to well Bose is the cause of your pain and you need a black dummies. That’s the sickness of this. That’s I don’t think people understand this is junk science. This there is no basis from a theoretical perspective in the use of the MRI. Okay.
Steve Washuta: Now, yeah, and I’m with you, and I hear you up to this point, and I am I’m not for the correlative information, throw that out the door, but I think maybe their argument would be there’s the causal is that if you have let’s say, you know, disc herniation that could be sitting on a nerve and then that nerve would be sending pain signals to a particular area. Am I incorrect?
Mitchell Yass: Very good. You just brought up the point. So when you have pain in your chest and your left arm, do you think you have an ankle sprain? You know, you say, oh shit, I think I’m having a heart attack. Because the heart creates a very specific set of symptoms.
Mitchell Yass: When your entire left side of your body goes numb, you don’t say, Oh, maybe I should check my knee, you say, oh shit, I think I’m having a stroke, because those symptoms are definitely correlated to a particular tissue, the brain. So we have to recognize, that Hippocrates himself derived the Hippocratic method of evaluating for cause to look at symptoms to interpret what tissue is creating those symptoms.
Mitchell Yass: So you just said, oh, oh, if it was a herniated disk and printing on a nerve, you should have a symptom with that nerve root, by the way, not a nerve, but a nerve root creates a symptom that is called the dermatome.
Mitchell Yass: That is called the dermatome. And if anybody looked at the lumbar dermatomes, you’d see they innovate your leg. Yeah. Okay. So that would probably indicate that if you’re painting your lower back, it’s probably not from that nerve root.
Steve Washuta: Very interesting. Yeah. And you’re right. So like, I’ve had clients who’ve had, let’s say, C 67, herniation. And they start complaining about pain in their shoulder blade that leads to, let’s say, a lack of use in their tricep, right as that nerve runs down there, and there’s a specific nerve root innervation.
And you kind of you know, that’s a causal effect. But you’re right, if you have lower back pain, it’s usually muscular. It’s not from a nerve in your lumbar region, because the nerves in your lumbar region are running elsewhere. Well,
Mitchell Yass: let’s also go to this point. So they’re being told you’re being told it’s from a herniated disc impinging on the nerve root, because it was found at the time of your pain. That’s it. That’s the only thing that goes on, but they’re never going to try to look at your symptom. So it’s okay. But let me ask you this. Is it the nerve root always in pinched? If it’s impinged, isn’t it always in pinch? You would think so.
Mitchell Yass: So you would expect your pain to be constant, with roughly a similar type of intensity, oh, wait a second, it’s never that oh, your bone on bone at your knee. But when you sit down, you don’t quite seem to have the pain. But when you’re weight bearing you do so sitting down causes you to no longer be bone on bone.
Mitchell Yass: Wow, that’s pretty cool. You see the psychotic nature of it, you have to look at the symptoms as a whole part of looking at symptoms is understanding what brings it on and what shuts it off.
Mitchell Yass: And if you’re gonna tell me a meniscal tear, or herniated disc, arthritis, any of these things of causing symptoms, you better show me that those symptoms are fairly constant, if the structure itself is responsible, Oh, that’s right. 98 to 99% of the people I’ve treated over 30 freakin years, that was never the case. And you’re not denying
Steve Washuta: that things happen like meniscal tears, right? They’re not real. They’re not happening. You’re just saying that the pain associated with it and the way they deal with it is improper.
Mitchell Yass: So the question is, no one’s going to deny that these things exist. You’re seeing it? The question is, is it creating your symptom? That’s the question. Let me ask you this. You’re 80 years old, are you 60 or 70 years old, you start noticing you’re having wrinkles on your face? Do you suddenly start getting skin grafts because your skin isn’t the way it used to be? Do you start panicking Oh, shit, my skin isn’t the way it used to be, I need to have skin grafts.
Mitchell Yass: No, because you say the integrity of the skin. It’s still intact. Even though there is a wrinkle there. It’s still doing what it’s intended to do protect me from antigens entering my body. Here’s the magic answer to the freaking world herniated discs, what’s right is to notice pinched nerves, any of these type things or wrinkles, they’re not cancer, they’re not cancer, the mere identification of them doesn’t mean you need to address them, because they’re not creating symptoms. That’s what everyone has to understand. Just because you have a malformation doesn’t mean it needs to be treated.
Steve Washuta: But part of the you know, part of the issue that I see on my end, you know, someone who deals with people and personalities on a day to day basis. It’s not just the medical industry, it’s that people do want a quick answer.
So if they came to you, Dr. Mitchell, and they came to me and we said, hey, you know, this, this pain is associated with a bad lifestyle choices over the past 20 years,
we can sort of slowly reverse these, but you have to put in some work that’s going to take a little bit of time, or they go to the surgeon and says we’ll just replace the joint. Some people actually just want the simple answer. And that’s really unfortunate.
It’s not just the medical industry, it’s people need to look inward and say, there are no simple answers. We’re going to have to work on this problem slowly.
Mitchell Yass: So so let’s see where we are now with this process of chronic pain, and you’ll start to recognize as a shitload more people who are willing to give up on this system as it is. So you’ve got the people who have had multiple surgeries, back surgeries, joint replacements, revisions and all this crap, they still writhing in pain, their lives have been taken away from them.
Mitchell Yass: You have the people who have gotten addicted to opioids, straight out synthetic heroin. Let’s not be confused about what this is. It’s synthetic heroin, end of story. They’re addicted to it. You have those people who tried surgery and synthetic heroin, and it has some work. And they’ve been told life’s done, you got to stay like that. US these people, any of those people, listen, I need you to do three exercises three times a week to make your pain go away.
Mitchell Yass: You don’t think most of them are substantial number of them are gonna say shit, yeah, I’ll do anything. Now, to get my life back, I don’t disagree with you, the initial person is gonna have trouble, they’re looking for that quick fix. But when that quick fix doesn’t work anymore.
Mitchell Yass: And you’re thinking maybe you can’t live another day on Earth this way. You’ll do anything. If I said, literally, you have to walk through shit, you’ll do it. So when I’ve done this for 30 years, by the way, 15,000 people, I’ve seen the worst of the worst of this situation. So where does it start? So
Steve Washuta: you know, let’s continue to go down that path of the let’s call it the patient experience. I’m a patient, I go to the physician, and they diagnosed me with whatever this low back pain and they can’t tell me what it does.
And then they go to the physical therapist, where’s the where’s the juncture in which you believe there needs to be a switch? Is it at the physical therapy level?
Mitchell Yass: No, it’s the first entering of the medical system. It is the basis by which the diagnosis is derived. Right. So let’s say, let’s give you like a classic situation. I’m a guy who sits at my desk and I sit there all day and I’m on my computer. And every time I tried to go stand up, I feel like I can’t stand up and I have shooting pain in my back and I just have to go to the floor.
Mitchell Yass: Right? Therefore and I get it, it takes me a while to try to stand up. Sometimes I can’t sometimes I can’t. Right. But it’s all seems to be when I’m setting it’s not the problem. It’s when I go to stand up, right? So you’re gonna eventually just can’t take it your lifestyle is being affected, you’re going to enter the medical system, you go to an orthopedist or a neurologist, you’re going to get an MRI, it’s going to find a structural variation, that whatever that structural variation becomes the basis of all treatment going forward.
Mitchell Yass: So I don’t care if you go for physical therapy, by the way, I have a doctorate in physical therapy, it’s worthless crap in the sense that it is a palliative care, go to the American Physical Therapy Association’s website, and they will say they are a palliative care.
Mitchell Yass: Palliative Care implies that it is done for nothing more than to minimize that symptom. It has nothing to do with diagnosing a cause. You go to physical therapy with the diagnosis of herniated disc, they think they’re treating you for a herniated disc.
Mitchell Yass: I don’t even know what that means. I think on a on a herniated or they go into stenosis is now ring of the space between they’re going to unstuck notes, it’s yours to notice. They’re going to untether your meniscus, what exactly does any of that mean? It doesn’t mean anything.
Mitchell Yass: So what happens is they become the next step. And here’s what happened. You went to that surgeon and he said, Listen, I know I’m a surgeon, but I really don’t like doing surgery. It’s really the last resort. I’m really nice guy I prefer I prefer not to do surgery.
Mitchell Yass: So what we’re going to do is we’re going to try all these nice conservative things. To try physical therapy and chiropractor. I’ll give you some anti-inflammatories, I’ll give you a quote out of all this stuff. But if it comes down to the fact that nothing works, do you agree as a last resort, you can get surgery, you would just be manipulated literally coerced into a decision based on a full set of circumstances.
Mitchell Yass: So that’s the process so you’ll try you have conservative things. Everybody who’s never got surgery tells me I would never get surgery. You have no idea what it’s like to have pain that so deadly, that you can’t even get out of bed. I’ve had people who would straight out bedridden from this level of pain. And for people to think and this is a number of other concepts, that misnomer that muscular pain can’t be brutal.
Mitchell Yass: I’ve had people whose piriformis muscle in their butt has gotten into spasm and sent them to the hospital. That’s one of my favorite other of like one of the things people say, who have had surgery and it didn’t work and eventually, you know, the symptoms came back and now I’m treating them they’ll say Oh, I definitely had to have that surgery because the pain was so bad. And they showed me the disc and had. So let me ask you this.
Mitchell Yass: You have a hernia. You’re one of those people who had a herniated disk and you have no pain. I know for sure you had no pain, I gave you an MRI, you have a herniated disc, and I hit you with a sledgehammer. I’m going to imagine that’s gonna cause a lot of pain because you have a lot of pain does that mean you have a herniated disc that wasn’t causing the pain that’s causing pain because the herniated disc because they have while you have the sledge hammer pain, of course not. It’s lunacy, lunacy and that’s what people have to understand.
Steve Washuta: And they have nowhere to turn to though. That’s that’s also the problem right? So you know, we’ll take your word, and I do agree with you that a lot of this pain is is muscular, right this is what is going on, but everywhere they turn to is telling them that’s not the case or if it is the case, they tried a variation no fixing it, that didn’t work.
And then the last step is surgery. But I will say, you know, in defense of some people in the medical industry, they are also inundated with so much stuff.
They don’t have the time to spend with the patient, right? So you walk into a doctor’s office, the clock’s ticking, they got 15 minutes to deal with you because of how insurance works because of how the offices have to make money. So it’s really not just the individual physician’s or practitioner’s fault. It’s the system as a whole.
Mitchell Yass: There’s no question. It’s cultural. This is a cultural predisposition. It’s the educational system that hasn’t changed. Go look at the curriculum of an orthopedist from 1970 something and look at the curriculum from 2022 or 2023. It’s identical.
Mitchell Yass: It’s identical they look for a meniscal tear. I find a variation to a meniscal tear of the knee, I’m gonna say unique surgery because that meniscal step meniscus doesn’t look the way it used to when I know that I can make it look the way it used to.
Mitchell Yass: That’s well, the idea that trying to associate that with pain has not been introduced into the curriculum. So they’re just doing what they’re told.
Mitchell Yass: By the way, I’ll just give you a little kind of statistic thing of people who don’t have pain of those people who do have knee pain. 63% were found to have been physical tears. People who have knee pain, 63% of the people who don’t have knee pain 60% are found to have been to school tears.
Mitchell Yass: So could you explain how meniscal tears cause pain? I don’t know. That sounds very weird to me. Sounds to me like it’s an independent variable. And it’s more wrapped, that the people in pain have a muscular clause, who happened to have just had an MRI while they were in pain to show them they have the meniscal tear. That’s what it sounds more like to me.
Steve Washuta: Do you see there ever being sort of a, I guess, a change of the guard here? And you? Are you I know you’re fighting for it? But is this an uphill battle that you think you’re never going to win? Or are you in this because you think that you can change the dealing with chronic pain the process of it?
Mitchell Yass: So I’ll give you a little sense of where I think I am. George Washington goes to Congress. And at one point, he is told to create the Continental Army to be the most powerful military organization in the world, the British, right? So when he goes off to start this thing, how many people are in the Continental Army, one, George Washington,
Mitchell Yass: he then has to go to Britain to Boston, where they’re having the siege, and he has to find some militia, and somehow kind of break them in and make them become a Continental Army, right, I’m going against the global behemoth. I’m going against the Global Medical behemoth that for 40 years has misled people into thinking that MRI is valid.
Mitchell Yass: And in fact, I could prove to anybody at any time it is theoretically clinically and scientifically baseless. I have done this 1000s of times, I would say the vast majority of people 98 99% of people who came in with a medical diagnosis from an MRI, I proved it was muscular and resolve their pain within weeks. I’m not saying they didn’t have the structural variation, I’m simply telling you, it was like a wrinkle and simply exist and will exist for the rest of their life.
Mitchell Yass: So I believe that I am being used by God. And this gets kind of quirky, but I think I’m being used by a higher power, I am the chosen one, to who has given this information, this capacity to know what I know. And to implement this in whatever way is possible. And to do things like go on podcasts, which a year and a half ago, I didn’t even know what the word podcast meant. But someone I treated told me that I should do this.
Mitchell Yass: And I started the process and I’ve been on over 80 already. I am being directed to do this. People can say whatever they want about it don’t matter to me, because I’m at peace now with myself and what I do, and my responsibility.
Mitchell Yass: And I believe that we are at the point where there is beginning to get into the ascension of awareness, you have two things happening, you are getting a greater and greater disillusionment with the medical system.
Mitchell Yass: And people are more and more out there seeking. And I am more and more making this available to people. And those two will eventually join together and we will create a people’s revolution. And I truly believe this is the path and I am prepared.
Mitchell Yass: I have created certification programs to then certify people as this gets outside of me. And we will get more and more people to implement this. And quite simply, we will simply move people away from that system to this system. And the process will take as long as it takes.
Steve Washuta: What about in general? What are your thoughts or your prescription about avoiding chronic pain as a whole having a healthier lifestyle? So that one doesn’t come down with the chronic pain in the first place?
Mitchell Yass: Yeah, so let’s talk about what the chronic pain is. And then we can understand if you understand what’s causing chronic pain, then you can understand how to prevent it in the first place.
Mitchell Yass: And as I said before, basically you live in a gravitational environment. And that’s always been And that means that anytime you’re trying to do anything other than like flat on the floor, you’re pushing against gravity.
Mitchell Yass: So there is a force requirement for every activity you do. There are specific muscles required to perform that for or to do that force do adapt to that force requirement.
Mitchell Yass: And so they have to have an equivalent force output. If all the muscles required type of force output don’t have that one muscle is going to break down, others are going to compensate, it’s going to lead to those have a greater force requirement than they need, or they’re designed to, and they’re going to strain and elicit pain.
Mitchell Yass: So the question is why recognizing that wouldn’t you develop an isolated strength training program, that only has to be done two to three times a week, that should take less than an hour each time, and then sustain a certain force output of all of your muscles of regardless of the activity you perform, you will never strain that that is my proposition.
Mitchell Yass: That is my point. That is where I want this to go. Eventually, I want people to recognize strengthening isn’t something about aesthetics. Now, if this was the 1960s, or 70s, when you were a farmer, or you, you know, you did things that required hard manual labor? Well, because you had a force requirement that was fairly rigid, your muscles had to sustain their strength to do that. That’s why chronic pain didn’t exist at that time.
Mitchell Yass: But now, if you plan on doing things that require very little manual input, then your muscles are simply going to weaken, there’s just no choice because you’re not forcing them to sustain strength based on the force requirement. So as a result of that, you will weaken and you will become susceptible to pain. So my point to everybody is you have two choices.
Mitchell Yass: If you want to be an IT person, then I assure you, you’re going to need to do some sort of targeted strength training program to maintain your strength so that you don’t strain and elicit pain, or go back and become a farmer again. That’s your two choices. It’s that simple.
Steve Washuta: I like it. And it’s the truth, you know, and personal trainers, like myself have worked with, you know, I work with a lot of seniors who have, you know, basically a lifelong journey of flying on airplanes and sitting on desks, and they have cervical column issues and bad posture and their, you know, their low back pain is because their, their their glutes, don’t fall Don’t Don’t fire, right.
They haven’t used their ass muscles in a while. And, and the funny thing is, there’s so many what I would call charlatans who push, you got to stretch. And what they do is they stretch, and they feel better right there. And then and they come back the next day and have the same problem.
It’s like, Well, you see, the stretching didn’t cure the problem, right? Ultimately, we have to strengthen it so that these things aren’t moving, and that we have the proper strength. And I think, I think like you said that word is getting out little by little people, people are believing that more.
Mitchell Yass: So you just go on Facebook, look at the feed. And every second to third thing is some sponsored advertisements for some dogshit thing that they think, oh, move your legs passively, and it’s gonna get you stronger, put this infrared thing on your knee and it’s gonna get rid of your arthritis, wear this thing on your head.
Mitchell Yass: And I mean, it’s it’s nonsense and have it you mentioned stretching programs, people have to understand that a flexibility deficit is not an entity unto itself, it is a byproduct of the relationship of two opposing muscles force outputs, like your quad in your hamstring or your bicep in your tricep. And if one is stronger than the other, the stronger muscle will short and thereby created the flexibility deficit.
Mitchell Yass: So you could stretch the stronger muscle as much as you want. It will never change the fourth deficit. The only way to resolve the flexibility issue is to strengthen the weakened muscle until the force outputs are equal. That’s what everyone has to understand flexibility is not an entity unto itself. Balance is not an entity unto itself.
Mitchell Yass: Balance is the culmination of two systems, the neurological system that semicircular canals and the cerebellum telling you where you are in space. And when you need to change yourself, they send signals to muscles to contract. So loss of balance is not from a loss of balance. That doesn’t mean anything. You either have decreased neurological capacity, or you’re freaking weak.
Mitchell Yass: And I could show you that if you sit with your, your torso, unsupported by your chair or anything, and you could find yourself centered. You don’t have a neurological capacity problem. Guess what? You’re freaking weak in your legs. That’s your balance issue.
Steve Washuta: Yeah, that’s a great Want. And I think that’s one of the bigger problems we have actually with seniors today is that quote unquote balance issue leads to a fall we have all the data, when they do fall, you’re basically in this downward spiral snowball effect where the chances of you living even another 10 years becomes very minimal because you become even more deconditioned.
Now you have to be in a wheelchair, and now you’re on medications. And before you know it, you’re no longer with us. So I think, you know, fixing that quote, unquote, balance issue, like you said, which is really just typically a strength issue is is very important.
Mitchell Yass: 100%. So I spent enough time with seniors, this is the way it works. Some older person fools, and their children find out about it, and they’re like, Oh, my God, you’re unstable. You are balances, you know what you need, you need a cane? Well, what do you think a cane does, again, transfers, weight support from your legs to your arm, even 20% of that variation takes 20% of the need of your muscles in your legs to support you.
Mitchell Yass: So what do you think’s gonna happen, you’re gonna make that it’s not going to make him leg muscles stronger, no weaker, you increase the speed and progression downward of your stability, which now leads you to say, oh, no, you know, that’s too unstable, you need a walker. Now, you could put 50 to 60% of your body weight through your hands, that just took 50 to 60% of your body weight that needed to be supported from your legs away from it.
Mitchell Yass: What do you think that does the alleged weakened step further, all? You got it? Once you’re in a wheelchair, that’s the death mark, you don’t come out of a wheelchair. Unless you know people like me or you who recognize that it’s a muscular deficit that’s actually responsible for their problem, not a quote unquote, balance issue.
Steve Washuta: Yeah, I think a lot of this too is that there are short term things that we do need, right? So no one’s saying that maybe you don’t need a cane when you’re by yourself just to get to the bathroom.
That’s fine. The there’s short term answers that we have here, right. But that shouldn’t be a long term solution. But the long term solution should be to get back to functioning without these things.
And I think that’s that’s a that’s another part of the problem is for the physician or the medical the health expert to say, we’re just using this literally and figuratively as a crutch, very short term, so that we can get you back to status quo and not get you stuck in this position forever.
Mitchell Yass: Right. So So let me ask you this name a physician, who is very familiar with strength training, and its effect on function. Can you point to just show me because I’m not too familiar with that? Um, well, I
Steve Washuta: mean, if if they were maybe an orthopedic or a sports medicine doctor, I would assume that they are but certainly not your general practitioner.
Mitchell Yass: That orthopedist knows one thing, structure of joint End of story, end of story, you don’t know nothing about the muscles, how they move the joint, which is called kinematic kinetics, or the actual how joints move surfaces move on one another called kinematics, they know structure.
Mitchell Yass: But that’s all they know. They know nothing. So I always find it very comical when this person says, and they come to me because they have shoulder pain that they haven’t raised anything overhead in 10 years. And they say, Well, I went to the orthopedist. And he said, I should never lift anything more than five pounds of night.
Mitchell Yass: And I’m thinking to myself, can I see that? What the pianist and I see that orthopedist and it’s a 350 pound dude, who can’t even walk get out of his chair. And I’m wondering, how did he know five pounds was the right answer. He’s well versed in weightlifting that’s interesting, doesn’t appear to be doesn’t have any educational background.
Mitchell Yass: But that poor schmuck with that goddamn name, Ted, with the MD was enough to get that person to believe they have some understanding, they have no understanding, no understanding of function.
Mitchell Yass: That’s the fact they know structure, and what it should look like and what it doesn’t look like and how to make it look the way it should. Again, that’s where it ends. Anytime someone tells me that a doctor, a physician, gave them some advice on function or how to live. I’m stunned. I’m stunned and irritated.
Steve Washuta: And ultimately, you know, the things like our hips, our shoulders are ball and socket, they’re meant to be moved in a in a circular fashion. And if you don’t move them in a circuit, if you don’t use it, you’ll lose it, as they say, right, we have to continue to move these things in all directions to make sure that we’re creating space in there.
And that we are that that that that joint is healthy, so to speak. And I do think avoiding movement again is one of those things where you have for a short period of time, if you have a serious injury, maybe you don’t have go towards this particular movement, but long term, someone should say someone should never say never lift something over your head. That term never is it has to it has to leave the the sort of the health space.
Mitchell Yass: Sure. So let’s just go to let’s let’s give some examples about what you just said, your kneecap is now in the back of your knee. I would suggest you probably should rest. Your arm bone is sticking out. I’m gonna say you should rest. If you strained your shoulder muscle. I don’t give a shit what anyone tells you. You don’t rest.
Mitchell Yass: You know rest you figure out which muscle is strained eliciting your pain and you cause that muscle to get enough force output for the force requirements of your activity and guess what? It never listened to pain again, every person that goes to a doctor and has pain is told to rest. If it’s muscular, that is probably the dumbest thing you could tell someone to do that, don’t you?
Steve Washuta: Why don’t you want blood flow to the area to help the healing process also in these non vascularized areas, right by movement, or am I getting blood flow to that area to help
Mitchell Yass: show you what but the real question is what’s causing the pain. If the problem is that the muscle strength because its force output was less than the force requirement that the activity had is not moving, it increased the force output of that muscle, I’m trying to figure it out.
Mitchell Yass: All it does is it limits it, it decreases force output by a lot by lack of use by telling that person to rest four to six weeks, you just incited that person to have a tougher time and resolving that pain or ever returning to function. That is a disgrace for that kind of thing to happen. I’ve had people who have had terrible muscular causes rising pain, they come to me the next day, they’re on the process of getting out of pain, if it’s muscular.
Mitchell Yass: That’s the kind of thing people have to understand. I want to pick up on another point you made. I want people to understand this premise. People get arthritis herniated disc stenosis, meniscal tears, all these structural variations. What’s the cause of it? What’s the quote people love to say that bullshit statement wear and tear? That doesn’t mean shit.
Mitchell Yass: That Do you think Jacqueline give it I guarantee if you took an x ray of Jacqueline shoulder with Jacqueline’s vertebrae, that wasn’t herniated disc stenosis or arthritis, and he was 95.
Mitchell Yass: What causes structural variation is the fact you started to describe it, your shoulder is a ball and socket, the way the shoulder works is you have muscles that attach from the shoulder blade to the arm bone, and they move the arm bone in the socket to allow for function,
Mitchell Yass: the best chance of that working properly is when 100% of the surface area of the head of the arm bone touches 100% of the surface area of the shoulder joint. That’s when the surface area diffuses the force optimally, and that’s the way God made the joint to work, then you get weakness or imbalance because you didn’t really understand the premise she was supposed to stand strengthen balance, and the head of the arm bone shifts over slightly.
Mitchell Yass: Now 80% of the surface area of the arm bone is touching 80% of the arm bone, that’s 80% taking 100% of the force requirement. That’s not a good equation. So what do you think’s going to happen, that excess compression because not 100% is touching, it’s going to start to wear down the hyaline cartilage that sits on the the tops of the two bone surfaces. Once that wears away, bone is exposed.
Mitchell Yass: Once bonus exposure, we then have deterioration of bone or hypertrophic bone growth. That is the osteoarthritic process. So what caused it to begin was misalignment of joint surfaces due to weakness or imbalance, you want to stop arthritis, you want to stop meniscal tears, you want to prevent any of this stuff from ever happening again, sustained strength and balance of muscle. That’s how God designed your joints.
Steve Washuta: And nobody would disagree with that sort of anatomical explanation you made, I guess what the physicians would say, and I know you’ll you’ll push back here is that for most people living their lives on a day to day basis, it’s impossible for them to be preventative enough for them not to have some of that slip for that not to go to 100, from 100 to 80.
Because they’re just living their lives, they have jobs, they have careers, they have things to do. And inevitably, they don’t have the time and energy to keep that from from stopping. But what you’re saying is they don’t need a lot of time, they just need a little bit of education. And they need about three days a week for an hour, and they’ll they’ll never slip up.
Mitchell Yass: So again, going back to this principle, if this was the 1960s or 70s, I would be nobody, I wouldn’t even have a job, I wouldn’t have anything to do because there wasn’t chronic pain. And I would have never been driven into understanding chronic pain, because of the fact that people were doing manual activity.
Mitchell Yass: And as a result, the force requirement, let they’ve forced outputs of their muscles to have to sustain it. And when you have that, you have the ability to sustain your muscle strength, which is why nobody was straining. And I assure you that with very little meniscal tears and all these other types of situations being identified or even existing. It is because of the fact that we have now become sedentary.
Mitchell Yass: And we are doing jobs that require no manual labor that our muscles are weakening and imbalancing to have such a higher level that it’s feeding into the speed at which these degenerative processes are occurring.
Mitchell Yass: So you have a choice. Again, be a farmer, or be an IT guy or an IT woman that recognizes that either they’re going to sustain strength and balance of muscle, or you’re going to have these issues develop. It’s your choice.
Mitchell Yass: You can do whatever you want. This is America at least for now. You get to do whatever you want. But I can give you the logic behind why it’s happening. I can present to you the empirical evidence of it, I can show you. I mean, you could take me, I’m 61, I started lifting weights at 26. I put on 60 pounds of muscle, perfect balance everything. If you look at my bony alignments, the rolling alignment,
Mitchell Yass: I defy anyone at 61 doing a 405 pound squat and a 405 pound straight leg deadlift, look for arthritis, find arthritis, find a herniated this five minute skull there, you’re never gonna find it, it isn’t there. Because I have sustained not just the strength, but the balance of my muscle. All my joints are perfectly aligned maximal congruency, perfect use of the joint does its as it was designed to be. I, someone want to defend that position outside of what I’m saying. I’m happy to discuss it.
Steve Washuta: What is so let’s go into some specifics here. As far as like workout and exercise routine, you know, you talked about the, I guess you would call the the high level thing, you know, with the force output. But what about specifics? Are you doing traditional strength training exercises? Are you focused on working particular muscles? On certain days? Let’s get into specifics of exercise?
Mitchell Yass: Sure, sure. So can I just and I know you’re a personal trainer, and I’m not attacking you as an individual, because I really don’t know that much about how you train or how you treat your people. As far as I’m concerned, the mid 1990s was a pivotal moment in personal training, it really related to the biggest loser in all these types of shows, where everyone decided that isolated strengthening wasn’t the direction to go, we were going to move towards functional training,
Mitchell Yass: it was kind of the advent of CrossFit and orange theory and the moving the tires and pushing the sleds, and I got no problem with that. But let me ask you this, someone has a week left hip muscle, right, they have a week left hip muscle, and they’re going to try to push that tie rover or they’re going to move that sled, what would happen if they tried to do that, if they’re weak on the left side, they’re going to compensate you have
Steve Washuta: compensations on the right side, then you have synergistic dominance, and then it’s then spirals out of control. So you have to, you have to fix it through some sort of corrective exercise where you’re focused on that muscle first, and then you could work. And from there
Mitchell Yass: You go. So I don’t, I’m great with crew, I treat huge numbers of CrossFit people, I treat Lots of athletes, I want you to do every activity that you love to do for the sake of doing it. But you have to recognize that activity by definition and call it implies that groups of muscles are being performing the activity.
Mitchell Yass: And therefore if there is a weakened muscle compensation develops, leading you to do it improperly leading to ultimately breaking down. So I want isolated strengthening to always be the basis by which we do what we do.
Mitchell Yass: Okay, and then do activity to make yourself happy activities should be joyful. And I agree and with the least chance of injury, so I believe in isolated strengthening now. Okay, so you could go
Steve Washuta: well, and I was gonna just piggyback on that I’ll let you go on. But the reason why that’s important because when you’re talking about activities, activities tend to repeat the same motions and the same patterns over and over, which can also create problems. So let’s say a golfer, golfers don’t swing both ways.
They’re only swinging one way, right? So you’re so as I take my arms backwards, I’m, I’m loading up in my lap, my serratus only in one direction, one shortening, one’s lengthening, and you’re repeating these motions over and over. So you have to have the strength training portion to sort of even things out for lack of a better term. Excellent.
Mitchell Yass: So let’s just bring up another point that relates to what you’re saying. This phrase overuse, overuse, oh, why did I hurt my what I have tendency over you. That doesn’t mean anything. That’s a foolish, it doesn’t it’s a meaningless statement, the usage of the muscles for that activity is fairly set. In stone. If I play tennis, I kind of play tennis the same way every time, I don’t suddenly change how I play tennis.
Mitchell Yass: So we have to assume that the force requirement is basically constant. The reason that it leads to pain is because the force output of all the muscles trying to perform that is not available.
Mitchell Yass: And as a result, one muscle couldn’t do what it needed to do compensated causing a force requirement greater than that what that muscle was designed to so when strains eliciting pain, so let’s, as a general rule, stop saying the word overuse and describe it as under strengthened, we have a much better chance of helping people in that regard.
Mitchell Yass: Now, the reason that it’s such a fun and exciting type of statement is because now if I say it’s overuse, well, now I could give you a brace, and I can give you anti-inflammatories and I can give you cortisone shots, and I can give you all these things to try to make it so that it’s a little easier for you to adapt to doing that. But you’re still never doing the one thing you need, which was recognize that certain muscles just aren’t strong enough.
Mitchell Yass: That’s the problem. It’s financially much more beneficial to the planet of capitalism, to say you have overused and to say you’re on to strengthen, because if you’re under strengthen, you just got to know which exercise to do. Do it yourself, and you don’t have your problem. anymore. That’s the problem with this, then I see, I’m a logician, I always see everything in pure logic.
Mitchell Yass: And I always try to establish cause look for, you know, resolve chords, establish cause resolve chords. So going to that that was just my little stick about overuse and kind of what you were talking about. So, but you are on to the other part of this, which is that certain activities use certain muscles much more than others.
Mitchell Yass: And because we do everything in front of us. Let’s say in the upper body, there is no question we’re going to use our chests. Our anterior delt, and our bicep more to lift, things do all this kind of stuff, as a result of that feast will have a tendency to shorten, because the opposing muscles in the upper back are weaker. And as a result, as they shorten. They change the lengths of these muscles, they change the length of the muscle in the upper back, and everything becomes susceptible to straining.
Mitchell Yass: So one of my primary concepts is for people to understand that if you’re going to do an activity. There’s probably some universal exercises. You will be needing to sustain balance of the opposing muscles that are not used in activity.
Mitchell Yass: So therefore, its outputs are equivalent to the force, outputs of the muscles doing the activity. So we could sustain balance, again. Maintaining optimal length of muscle. An optimal congruency of the joints that those muscles are moving.
Steve Washuta: In your program, do you need actual physical weights? Could you use bands? Can you use cable machines? Can you use any of these forces to still create this? Or are you waits only?
Mitchell Yass: No, no, you kind of hit the point. So I don’t really care about the mechanism by which the resistance is created. As long as we’re using the appropriate resistance. And that that’s a whole separate type of issue is for people to understand. You know. you see people letting they go to the gym. and you know, they’re talking to their friend and kind of doing that thing like that.
Mitchell Yass: And like, Do you really think you’re doing something you can possibly think. And I don’t have a again, I don’t know if you want to do that. And that’s your thing. That’s cool. But then don’t come to me and tell me you didn’t get stronger. That weightlifting doesn’t work, because you’re not doing it. Right. So you got to use a resistance. That’s enough to allow that muscle to respond. By creating more muscle mass and adapting.
Mitchell Yass: And that’s how you get stronger. So you got to establish what the proper resistance is. One of the big things I have a complaint about is that I think. That there is just a lack of understanding from a fairly high perspective. And I primarily work with people with massive levels of pain. I don’t work with just the general population. Usually unless they’re coming for a specific reason.
Mitchell Yass: So I have to be very, very accurate in how I’m going to cause that muscle to contract. So I really would love to see a maybe a slightly higher level of understanding. of how to isolate these muscles. So because that technique has to be very accurate. If not. You’re going to compensate and bring in other muscles. and you’re never really going to be isolating that muscle.
Mitchell Yass: So you know. Just having a real good understanding of exactly how to ice what that muscle does. Each muscle moves one joint one direction. So we want to make sure we’re doing that with the proper resistance. That’s the basis of kind of how I do my weightlifting. People use bands, free weights, any of that stuff. I’m willing for any of it.
Steve Washuta: Yeah, it’s a it’s an interesting thing. When you’re working with clients to try to teach them kind of that mind muscle connection and saying. Do you understand which muscles firing here, you understand when I pulled this way that this muscles firing when I released this way that muscles now lengthening
And this muscle shortening and what is going on but it’s important for them. to know and not just stick them on a machine and say do 10 repetitions, right? Explain to them while they’re working the muscles. So they can build that mind muscle connection so that they don’t need as heavy as weight. And that they can they can properly build these muscles.
Mitchell Yass: It’s so fun to use. So I can’t tell you how many times I’ve treated people they’ve gone for physical therapy like 3050 80 times. I will say what did they do when they said well. They had me do a band and they did this and then they did this they did this or less.
Mitchell Yass: And so I always said always so did they ask you like would you feel it? Yeah, widget No, no no, I just did three sets of 10 that they said. do they have to read and and so. Then they’ll come to me and I’m like where did you feel it like. I’m so trying to get the gluteus Medius muscle with hip abduction.
Mitchell Yass: I mean, You got to feel it one spot in one spot. Only and you have to have that example. And I go through this and this time I spent recently with someone 20 minutes on one exercise. Yes, why the minutes and the
Steve Washuta: nuance of even small things. So if you’re grabbing a band, the amount you grip that band is going to completely changed the exercise right? So if I’m death. Death gripping that band. My forearms are now hyperactive in the process of me pulling it backwards.
So or my arm my traps and some of my other muscles in my back firing to the same extent. No, because I’m death gripping that fan, right? There are all these little nuances that you’ll that needs to be explained.
There needs to be constant strategic two way communication. The client who’s doing the exercise saying. Do you feel here? Do you feel it here? Even looking at their body and analyzing and seeing like is my bet is that bicep engaged here, we don’t want it to be engaged. So we have to, we have to redo this exercise,
Mitchell Yass: I see what you’re saying, to me, is something. I just would love to have a conversation with everybody in the fitness and medical world. that’s working on trying to develop strength, it’s got to be serious, man. It’s not a game. It’s not entertaining that person.
Mitchell Yass: I mean, it’s sad to say, and I don’t know if you’d agree with me. But I think a lot of people in the fitness world kind of don’t really haven’t invested the time themselves. To really understand what they’re supposed to be doing. And it becomes more of a social interaction thing. Because it’s a way of diverting. From the fact the person is really not getting the benefit.
Mitchell Yass: And so as long as they liked me. Maybe they’ll keep coming with me that you ever see someone work out when I’m with them. It is so freakin serious. And I am so extreme in my focus, and they are too. I’ll have people do three bullshit exercises. and they are exhausted, exhausted at doing three little exercises, because I’ve done it so accurately.
Mitchell Yass: They were their weakest muscles they had. We use just the right grip amount of resistance to cause them to be to be working at the optimal. So they can grow the fastest, and they are exalt they’re huffing and puffing, doing the smallest little movement. But that’s what this has to be in. And that’s what people what it ultimately comes down to is I am.
Mitchell Yass: And this gets a little quirky. Again, I believe I’m a servant of God, a higher power. I’m here to simply provide this gift that I have been given to people. I have nothing to gain from the React the interrelationship from me and that person. it is all them, it is all them, I am devoting my entire being to them getting benefit. So that with that understanding, you recognize it’s all about them.
Mitchell Yass: And you’ve got to give everything you got. And it’s got to be serious and specific. And I think if you’re taking that approach, the person’s gonna get the results they want. And they’ll refer people to you and all that kind of stuff. But if it’s just kind of something you’re doing. Like it’s a profession or a way of making money, I think you’re just missing the mark. And I just really feel it’s an injustice to people. And I am all in this for people.
Steve Washuta: Well, there’s a lot of bad information out there. But hopefully, you know, the glass half full, the good information will beat out the bad information and you know. Information like yours that you’re spreading will start to become more mainstream now that people have access to things and people will. Especially people with chronic pain will have no choice, but to listen.
This has been great information. And I’m sure we’ll do this again. we’ll get maybe into more details about like specific things. Especially now that towards the end when we were talking about the lifting, but let my listeners know now where they can find you where they can find your Instagram anything about you and then I’ll link it all below in the description.
Mitchell Yass: Sure. So very important. Understand, I don’t care who you are in the world. If you have pain, you deserve to be out of pain. And if you reach me by email, I promise you I will respond. My email address is Dr. Mitch at Mitchell gas.com It’s Dr. MITC H at Mitchell house.com.
Mitchell Yass: You could certainly go to my website live without pains. It’s plural live without pains.com. A lot of information on there will free content. If you decide you want to contact me there there’s a Contact Us button. Also, if you decide you want to have a session with me. You can either do an in person session I’m in Jacksonville, Florida. Or I’ve been doing zooms since 2015 anywhere in the world.
Mitchell Yass: I’m happy to do them. My YouTube channel is probably the best place. To get the best largest amount of free information about the method it’s Dr. Michel Yasser. That can be seen on YouTube, I think that’s your best bet for getting information. And my only point to everybody is never think there’s not an answer.
Mitchell Yass: I know many people have been living in pain for long periods of time. And you becoming disillusioned, do never, never stop never give up. I’ve worked with too many suicidal people to know that is a bad path to go. You have to believe there’s an answer. And you have to keep trying. I promise you you will find your path there one day.
Steve Washuta: It’s a great message. My guest today has been Dr. Mitchell. Yes. Thank you so much for joining the children podcast. Thank you appreciate it.
Steve Washuta: Thanks for joining us on the Trulyfit podcast. Please subscribe, rate, and review on your listening platform. Feel free to email us as we’d love to hear from you.
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