The Niggle You Keep Ignoring

SPEAKER_00 0:00

So you're thinking about running, but not sure how to take the first step? My name is Brian Patterson and I'm here to help. Welcome to Brian's RomPod. All right, welcome back to Brian's RomPod, and it's me, your host, Brian Patterson, the place where we don't just talk about running, we joke about staying in the game. Now let me ask you something. Have you ever felt that little niggle on a run? You don't know you don't know the one, you know the one. Not quite an injury, not quite right either. So what do we all do? We ignore it, maybe stretch it out for 30 seconds and hope it just magically disappears by the next session. Well, today's episode, it's all about why that approach might be exactly what's holding you back. Because joining me today is Dr. Michael Bettler from CT Sports Recovery, a guy who's seen it all when it comes to injuries, from his background in surgery to now helping athletes recover and perform without going under the knife. He's built his whole approach around one big idea. Your body is designed to heal if you actually give it the chance. In this episode, we're going to the real stuff, why runners consistently get it wrong when it comes to injuries, and why so many of us end up in the same cycle of pain, rest, and repeat. And most importantly, what you can start doing right now to stay healthy and keep running long term. So whether you're dealing with a stopping injury or just want to make sure you don't head towards one, this episode you'll want to stick around

Meet Dr Michael Bettler

SPEAKER_00 1:45

for. So let's give a Brian's Rumpod welcome to Dr. Michael Bettler. Welcome. So how are you doing? Uh shall I call you Michael, Dr. Bettler, or bigger? Michael's fine. Yeah, that's great. Excellent. So um I usually start with most of uh my interviews to find out a little bit what was your uh what were you like growing up in kind of high school? Were you very much uh a bookworm into your books? Had you always wanted to get into the medical profession, or was, you know, um athletics, you know, part of your um curriculum, as it were?

SPEAKER_01 2:29

Yeah, so um always been around sports. I grew up in Pittsburgh, which is a big sports town. So soccer when I was younger, baseball, got in football, American football, uh wrestling, and through software and javelin. So it's more of the ground sports, but obviously life conditioning within wrestling. Um, so it's always been a part of my life. I've always wanted it to be a part of my life. Uh also a book where um I was in, you know, all the advanced classes and all those things and wanted to go to med school from when my chemistry teacher sent me to uh a youth leadership forum on medicine at Georgetown University.

unknown 3:03

Right.

SPEAKER_01 3:03

Kind of fell in love with all the things that I saw there. Um also liked engineering um in chemistry, so I ended up doing a background in chemical and biomedical engineering for my undergrad, which kind of set my viewpoint from an analytical, evidence-based point of view. Um, and then got into osteopath, not uh on purpose, I guess. I went to allopathic school because that's what everybody knows, CMDs. Um found out about this other pathway and applied, and I'm actually really happy I did because of all the things I've discovered as far as approach to patients, things like that, since I've gone through it.

SPEAKER_00 3:36

Yeah.

From Surgery To Prevention

SPEAKER_00 3:38

So so basically, sort of from obviously from you know, going from high school and into into university, so obviously your your path has been um going into into into medicine. Um and I know going from the intro, um you you went sort of you went into surgery, is that is that right?

SPEAKER_01 4:01

Yeah, so we so from I didn't know I was going into surgery, I guess, is the first part of it. Yeah. So uh the first physician in my family, so I kind of didn't know what the pathway was like, to be honest, and didn't know what it would what I would be experiencing. So uh third and fourth year of medical school is when we do our clinical rotations, so I've been seeing all the different things. Um, I did like sports medicine, um, but here sports medicine, you have to either mix it with family practice or orthopedic surgery. And I didn't want to do the primary care part of the the family practice, which is what most people do. It's hard to very to get a very isolated sports medicine practice. Um, but as I learned the osteopathic manipulation, I had a table that my mom had got me when I was a first year student. I had always used it on family and friends and and had the table available. So it's something that uh has always been there. What I liked about surgery was the fast turnover of the patients, they come in with something like an appendicitis, you take out the appendix, they get better, you have a relatively definite problem that you're working on fixing. Um, and there's ranges of how sick people are when they present, obviously. Um, but what happened was uh surgery is a very intense field. Um and as I started having kids, wanted to be part of their life a little bit more, was on call every fourth weekend and every fourth day, it just was a lot. So you work a lot, it's high stress, um chronic disease risk. Um, and you know, talking to patients, telling obese patients or patients that don't eat very well about fibroticulitis and gallbladder disease and what you should eat and what you shouldn't eat. Um, it was very hard to get that population to want to listen because you know they're there for a very short amount of time. You don't really have a relationship with them. Um, so I I wanted to get to people before that.

SPEAKER_02 5:46

Yeah.

SPEAKER_01 5:47

And people that were interested in hearing about what I was trying to say to keep health, get into longevity. Um and I ended up doing a functional medicine um position that's through telehealth that really sparked my interest. Um, did a master's in biomedical ethics because I was always interested in the ethical side of things. And for my end, the ethical side of things is why are we waiting until people get sick? Why don't we try and prevent that in the first place? Talk to people, say this is what you can do to prevent it, eat eat well, um, exercise, sleep well, and I can help you do those if you're having trouble. Um, and really got into the lifestyle medicine certification because that's that was where my interest was going in the future. Right. And it was also for myself because I was unhealthy um because of the stress of the job, waking up a lot, eating all new things. And I really, with myself, even as kind of my pilot patient, I guess, changed my diet pretty severely, got back into running uh yoga, things like that. And right when the pandemic was had hit was really when I started changing my life for the better, because I took the opportunity as as a way to better myself and try and bring that to patients, um clients also.

SPEAKER_00 6:59

Right. Was

Building A Sports Recovery Clinic

SPEAKER_00 7:00

there um uh I mean when you're in surgery, was it like you were moving from sort of something where you had kind of kind of quite a stable income, although I understand that you there was some stresses, you know, uh uh, you know, work stresses, you know, on mental and physical as it were. And then you were deciding to sort of move away from that to kind of a very different area which maybe financially might not be secure. Is that right? Am I or am I gonna get wrong?

SPEAKER_01 7:29

Yeah, you're not you're not wrong.

SPEAKER_00 7:31

Right, okay.

SPEAKER_01 7:32

Surgery pays well, I do about one week in a surgery a month still so that I keep my board certification and keep my um but but I don't get paid as well as I would if I had a primary job in surgery.

SPEAKER_02 7:43

Yeah.

SPEAKER_01 7:44

But and we're also starting our own business. So we started from scratch about four years ago, and we're we're working on building uh what we can to kind of outreach and tell these people like, look, there's this middle ground between needing something to be operated on versus the primary care doctors not really knowing what to do with pain that come in and we can help you. And I've developed and kind of curated all these different technologies, hands-on techniques, um, other staff members to try and make sure that if you have something going on, we we can help you, or we have a network of people that we can send you to that that can benefit you as well.

SPEAKER_00 8:18

Yeah. So I mean, I can understand and well understand um your situation in terms of preventative care, because obviously when you were in surgery, it was is obviously uh it was post. So it was like, you know, that the either you've been injured or, you know, you're not just injury, but either you're, you know, something has happened to you. Um whereas I think I probably from where you're coming from, you feel that you could make a difference um before it gets to that point.

SPEAKER_01 8:52

Right. And and the goal is number one, eating healthy and and exercising obviously is the base of avoiding dementia, avoiding chronic disease risk, avoiding inflammation. Um, and that's really the base of health is avoiding inflammation as much as possible. And and I think it's hard for patients in general, they're always looking for someone to help them and guide them. And and you know, I just wanted to present myself as I'm here and grow the availability of resources that I have to help patients with as we move forward.

SPEAKER_00 9:20

Yeah, yeah. Before

Healthspan And Evidence Based Care

SPEAKER_00 9:22

we sort of get into, you know, some of the techniques you use, so what is it? Is it is it um you set it yourself as a business, so you're saying that is it clients will come to you for who aren't necessarily athletes or maybe recreational runners or something like that, but to is it more for them, for you to give them advice as to you know how to kind of put them on the right path?

SPEAKER_01 9:50

Yeah, I think everybody, it's a it's a varying level of advice that people want. Some people come in with an injury and they know what treatments they want and they say, I want to do that. Some people come in and they say, I have this injury, what can you do to help me? So there's there's a mix of what people come in with and the opinions that they come in with. And you know, it's important to work with everybody, it's important to listen to people and hear what they say because I think a lot of physicians also don't take the time to listen to people. So hearing what caused it, what the issue is, and and using the best options that I have available to guide them, um, and also understanding the mappings 100%. So I may not be able to help everybody, um, but I want to be able to do things for as many people as possible.

SPEAKER_00 10:31

And did you find that over the years that when you were because um I underst obviously your your practices within the US and maybe there are very similar trends which are over here in the UK, but um did you find that there were in terms of people who weren't very healthy over the years it was they people weren't getting healthier, or maybe they were getting healthier as they're becoming more aware of what uh exercise can do to them um in terms of making and also being uh sort of general well-being and having eating well, sleeping well, that kind of thing. Um had that changed over the years?

SPEAKER_01 11:14

I I think there's definitely much more awareness of things that we can do as individuals to help ourselves as opposed to going to the doctor and having them do everything for you. Um I think there's been a change from that being the case to people kind of not listening to their doctor and wanting to do things on their own. So I think it's important that there's a relationship there where you can work together and even having Chat GPT or whatever AI are used more and more. Um, being able to translate that for people. So I think that those those are not always giving you the greatest advice. But if someone comes into me and says this is what chat GPT said, I think helping to interpret studies that play sound on there and things like that is important to be able to do and be open to us. Yeah. Um but there's definitely a a much greater movement towards wanting wanting health span, uh healthy while you're alive, as opposed to having a downturn in your 50s, for instance, and just kind of sitting still and not moving and not doing anything for yourself and hoping that the medicines will keep you alive longer. Just want to be alive longer. I think in terms of people are understanding that they want to live longer, they want to have the experiences after retirement, they want to have the experiences with their child children and grandchildren, great-grandchildren, that they can stand up and play with them and sit on the ground and play with them and healthy enough to do that.

SPEAKER_00 12:32

Do you think I know sometimes that the medical profession gets sort of um a bit criticized for let's say other services like um physiotherapy or osteopathy or um um other services that treat general health ailments that basically the um and I don't know if it's the same in the US that sometimes the medical profession is being a bit sort of short-sighted, they might just give a pill. Uh I don't know if is is that the s the situation in the US sometimes?

SPEAKER_01 13:02

That there isn't this kind of yes, there's there's some like inherent skepticism of people that that have alternative pathways to mainstream medicine for sure. Um, but but again, I think people in general are are learning to be more skeptical and more take the control of their own health more. So they are looking into the research behind these. And one of the things that I've done with my clinic is I try to make sure that everything has some evidence behind it and make sure that it is something that that will work or has been proven to work, so that I'm not having something that is like gimmicky or something that that I'm just trying to sell. I I don't want to just sell anything, I want people to get better. So I I think that it can be hard sometimes to parse that out because there's a lot of um kind of like wolves and sheep clothing, I guess, yeah, so to speak, that are out there that are trying to make money off of you with things that aren't really gonna help you in the long term.

SPEAKER_02 13:51

Yeah.

SPEAKER_01 13:52

But but like the things that I do with the realignment and the nutrition focus and everything, I think it's okay to look at those alternative pathways and and interpret them as you see fit and and do what works for you to make you better.

Simple Injury Prevention For Runners

SPEAKER_00 14:07

So in terms of let's say if we get into the meat of it in terms of runners, what are there any kind of steps that we can take as runners for injury prevention? In for you know, in terms of what's what advice can you give?

SPEAKER_01 14:22

Yeah, so I I mean shoes are one of the biggest things making sure that your shoes are good and change your shoes over every so often as far as miles and everybody's gonna wear down at different rates. Yeah. 150 to 250 miles, change your insoles every once in a while. If you have access to somewhere that has like a gate analysis to help guide what shoes you buy, so your your footfall is good. That's another one. Um, the realignment that I do here, one of the goals is making sure that you prevent injury. So getting realignment, uh gentle chiropractic, uh, whatever type of realignment you like. Um, even physiotherapists sometimes do manipulation to keep your your body as even as possible, keep the sympathetic and parasympathetic nicer systems in balance, keep your blood flow good, keep your lymphatic flow good, so that you have the ability again to heal yourself and and keep the inflammatory markers down. Um, I mean, two of the kind of most long-term players in professional sports, if you look at uh from an American side, I guess. Yeah. Michael Michael Jordan and Tom Brady were of realignment, and they would get realignment every week to keep them at the top of their game. And they were very healthy people. You look at Tom Brady's diet, uh the guy was eating so that he didn't injure himself. He wasn't going out and indulging in doing all these things. As he got older, he understood the importance of these things to to make sure that you can stay at the top of your game from an injury prevention standpoint and allowing your body to optimize itself.

SPEAKER_02 15:50

Yeah.

SPEAKER_00 15:51

And

What Realignment Really Does

SPEAKER_00 15:52

um on the alignment side, can you explain to my audience as to what does that mean?

SPEAKER_01 15:59

Yeah, so uh alignment, um, the way that osteopaths believe in it, um, basically what you're doing is you're trying to balance um the system. You're trying to get everything back to symmetry. So you can have a hip that's out of line, and if your hip is out of line, then you're gonna have leg length discrepancy. Leg length discrepancy will can injure one side. If one side is injured, you're gonna end up favoring the other side, so you get injuries on the other side or on other joints. So leaving that alone and kind of going with that long term will end up leading to chronic issues. So the goal would be to um as much as possible, and sometimes depending on the person, I'll recommend different intervals for whatever works for them. But every four weeks, every six weeks, every eight weeks, getting checked out, making sure things are in balance. If you have any little pains or anything like that, uh I know we have that in talk about, but not ignoring the little pains is very important too. Yeah. Um and kind of looking at it from a whole system, again, footwear, making sure that everything's balanced. Um, the realignment can help with breathing as well. So adjusting the first herb, relaxing the diaphragms, making sure everything's in balance so you can take those deep breaths. Yeah. Um, there's been studies that have shown that it improves your VO2 max as well. So these are all things that if you do them chronically or or religiously, for lack of a better term, they they can help uh keep you kind of optimal.

SPEAKER_00 17:19

Yeah.

Strength Training Plus Proper Recovery

SPEAKER_00 17:20

And is there I mean, I've heard and as I get older, uh the the thing I find is that um, and I've heard this from other coaches, is that we tend to, although when we're younger, do running, do various training programs. Uh, but as I said, as we get older, we tend to ignore the strength sort of side of things and how that needs to become incorporated more um as part of one res one's regime as well as the the aerobic side. So, you know, what are your thoughts on that?

SPEAKER_01 17:58

Yeah, so there's definitely a lot of research in strength training as far as longevity, dementia, and things like that. It's one of the most important things. Uh, definitely very good for bone strength. Jumping exercises are extremely good for bone strength to keep that in in check going forward. Um as far as runners, you want to balance because the cardiovascular system will adjust to the cardio from running and jogging. Whereas if you add in weight training, you kind of vary your weights, um, you can kind of trick your body, and there's actually more stress on the cardiovascular system with weight training than there is on and so it's a good adjunct um to make sure that your body doesn't get too used to something so that your metabolism can stay up.

SPEAKER_02 18:41

Yeah.

SPEAKER_01 18:42

Um it's just important to vary it. And for me, running is great from a cardiovascular standpoint. One of the best things for me about running is it helps to strengthen my memory because you're balancing both systems, you're activating both sides of your brain.

SPEAKER_02 18:54

Yeah.

SPEAKER_01 18:55

Just getting out into nature helps helps you from a mental standpoint, even raise your endorphins just to step outside and get some sun on your face is important. Vitamin D goes up when you're outside, so that is something that definitely helps longevity because it's good for brain health. Um, but I you know, everything in balance. So the strength training is definitely a good part of it. We'll keep your bones strong so that you can prevent shin splints and things like that, or hip issues, um, and keep those muscles strong that so that like say you swish your ankle or something while you're on a run, if you have stronger tendons, stronger joints, you're gonna have less likelihood to get injured if not.

SPEAKER_00 19:31

Will you would you just would you prescribe um a particular program for your clients, or would you just say you need to do more strength training and then maybe hand them you know over to to someone else who could prescribe them a program?

SPEAKER_01 19:47

Yeah, so I I try to work with people. I think that core imposture training is kind of a good base for everybody. So um physical therapy, we have some videos on our website for that and also for breathing for pelvic floor.

SPEAKER_02 19:58

Yeah.

SPEAKER_01 19:59

Um it's important to do kind of whatever you like to do. Yoga is great for strengthening and lengthening muscles and working on flexibility. Pelodies is another one that's great for muscle building and joint strengthening and tendon strengthening. So doing something that you like is very important. Um it's just important to kind of stress your body so that your body knows how to respond to it. Um, and then obviously the other side of that is you want to make sure that you have the time to recover. So getting the rest so that your growth hormone can go up so that you can do that repair at night when you're sleeping is the other side of the activity. The activity ends up breaking you down, whereas the recovery part ends up building you up and making you stronger.