The Retirement Success in Maine Podcast Ep 123: Move Better, Feel Better: How Physical Therapy Helps Retirees Stay Active

 

 

Transcript:

Intro (00:01):

Do you struggle with what it means to be successful in your retirement? Trust us. You're not alone. Welcome to the Retirement Success in Maine podcast. Here you'll go in depth with GuidancePoint advisors investment consultants to hear stories about how retirees in Maine are navigating a successful retirement. Get insight into the inevitable challenges of aging and define what a successful retirement looks like.

Ben Smith (00:26):

Welcome back everyone to the Retirement Success in Maine podcast. My name is Ben Smith and joining me as always is the ice pack to my sore hamstring, the foam roller to my tight back, my cohost Curtis Worcester.

Curtis Worcester (00:41):

I'm starting to get a little concerned, Ben. We're getting a little specific with these examples and ailments here. I don't know what's going

Ben Smith (00:47):

On. Well, yeah. Well, of course that's because today's episode's hitting close to home for a lot of us. And one thing we hear constantly from our clientele and retirees is they want to stay active and they want to travel, they want to play golf, they want to hike, they want to play with their grandkids. But sometimes the body doesn't always cooperate the way it used to.

Curtis Worcester (01:08):

Yeah, that's right. And sometimes that's because of maybe specific injuries or surgeries, but other times it's just accumulation of years. We have arthritis, back pain, shoulder issues, knee issues, things that generally start to limit mobility and maybe even our quality of life.

Ben Smith (01:26):

Exactly. We've had strength coaches on gym owners and we've talked mobility and staying active, but today we want to take a slightly different angle and that is the physical therapy perspective.

Curtis Worcester (01:38):

That's right, Ben. And that's because physical therapy isn't just what happens after surgery anymore. It can also help manage chronic conditions, reduce pain, improve movement patterns, and keep people doing the activities they love.

Ben Smith (01:51):

Yeah. And today's guest is someone I've personally worked with. And as some listeners know, I'm always trying to improve my own golf game and our guests today has helped me work on mobility and movement patterns that not only help me swing, but frankly, are the same things that many of us should be strengthening as we age.

Curtis Worcester (02:07):

That's right, Ben. And so everyone out there, whether you're trying to recover from surgery or reduce pain or simply just move better in retirement, I think this conversation should be really helpful for you.

Ben Smith (02:19):

Yeah. So our guest today is Dr. Trevis Deabay, founder and owner of Deabay Physical Therapy here in Maine. He grew up in Millinocket and has always had a passion for the outdoors and staying active. That interests in both medicine and fitness led him to pursue a doctorate in physical therapy from Husson University, which he completed in 2013. After beginning his career working in Rhode Island and Virginia, he returned home to Maine in 2016. So we like the boomerangs. His advanced training includes the functional movement screen and selective functional movement assessment systems, which focus on analyzing how people move to identify the root cause of pain or dysfunction. He's also certified by the Titleist Performance Institute to help golfers improve their mobility and performance. And his additional training includes vestibular rehabilitation, trigger point dry needling and the Graston technique. He started his own practice providing in- home physical therapy, allowing him to keep a smaller caseload and focus deeply on each patient's needs instead of rushing through appointments.

(03:18):

He also serves as an adjunct instructor at Hassan University's physical therapy program. So at this time, please welcome Dr. Travis Deabay to the Retirement Success in Maine podcast. Welcome, Travis.

Travis Deabay (03:29):

Thank you. Thanks for having me today.

Ben Smith (03:31):

Yeah, we're excited to have you. And I know with our show, we'd just like to get a sense of you a little bit, Travis, and just hear a little bit about your background. So love to hear a litle bit of what drew you into physical therapy as a career.

Travis Deabay (03:45):

Yeah, so I got here a little bit different way than some people. I was just generally interested in medicine and I'm not certain 100% what drew me in that direction even when I was in high school, but I wanted to initially become a physician assistant. I thought I was going to get into emergency medicine. I started college at the University of New England and was able to actually even get my EMT basic license in my first year, first and second year. So started working up in Millinocket, East Millinocket on the ambulance and really enjoyed it. Super exciting work most of the time, but kind of started to realize that I didn't want that kind of degree of pressure and that kind of responsibility of life and death decisions on my hands. So I had shadowed physical therapy a couple times. A few of my friends in college were in the program and I realized this maybe fits a little better in terms of being in the medical field.

(04:48):

I always loved athletics and being active, so started to just go down that direction. Then I transferred up to Husson to complete the undergrad and then the doctorate phase.

Curtis Worcester (04:59):

Nice. That's great. That's great. And I know we just kind of read this off, but of course you grew up in Maine, but then for a short period, it sounds like worked and moved in other areas, other states, but then of course returned back here to the state of Maine. So we just like to ask again, we're here in Maine. So what led you to come back to Maine and really build your practice here?

Travis Deabay (05:22):

I was always going to come back. I think it was just a little mini adventure and wanted to go see some different areas, try out different parts of the country. I thought maybe end up doing full-blown travel PT for a litle bit, but ended up just finding a couple good jobs, a few good areas, but realized pretty quickly being in both wanted to be closer to home, family, friends. Yeah.

Curtis Worcester (05:45):

Yeah, of course.

Ben Smith (05:46):

That's the pull that Maine has, I think. It's tough to leave the family and friend. And again, it's a great place to live, so we're very fortunate to be here. So Travis, love to ... Obviously you eventually started your own practice with an in- home model and smaller patient load. Can you talk a little bit about that motivation behind that approach and maybe why your own practice was a little bit better for you than maybe joining and established one yourself?

Travis Deabay (06:12):

Yeah. So when I came up here, I was working for an awesome company, Dragonfly Physical Therapy, and in that I grew up within that company but saw myself wanting to just start my own thing at some point. And so it was the combination of wanting to start my own practice, seeing a huge need in the in- home model with insurances cutting back on home care more. There's a lot of people that get caught in between where yes, they can get out of their house, but they don't necessarily, it's not very easy for them to. And then there's the clientele that's just incredibly busy. So I was working with two groups of people, seniors that were having difficulty getting out to a clinic and then people who was like, "I can come over, you're working from home. It's right after COVID, pop in for an hour.

(07:04):

You don't have to go travel anywhere. Your appointment's entirely wrapped up within 45 minutes rather than your 10, 50-minute drive waiting in the waiting room, that sort of thing." So it was that seeing a need, being able to then have my caseload structured and really focused on just a few people and one person at a time, getting all of my attention. And to be truthful, me being pretty risk averse in starting my own company, that was a way to do it with very low overhead for just the cost of what equipment I could buy. And I don't really need a lot to get started and be able to drive around and do that sort of thing. Unfortunately, what I ended up finding is that it was a great way to start my business. I made a lot of great connections amazing folks that still see me here in the clinic is that I was physically wiring down from all the driving.

(07:56):

So it got so busy that I was like, I'm just burning myself out here. So yeah, I still get a lot of referrals for it, but now I'm mostly exclusively just here in the clinic 95% of the time. A few folks that have kept with me, but yeah.

Curtis Worcester (08:11):

Gotcha, gotcha. No, I appreciate you laying that foundation for us and really want to dive into today's conversation. It's all about moving better, feeling better, and that relationship that physical therapy can have with that for specifically retirees for the sake of this conversation. I think a lot of people, even including myself, probably lump physical therapy as something into what you do after a surgery or after a major injury. Can you just explain, I guess again, laying a foundation, I guess again, if you will, of what physical therapy actually is today and maybe the broader role it can actually play in somebody's health?

Travis Deabay (08:53):

Yeah, so we certainly do a lot of post-surgical care, but most of it, particularly in my clinic, there are probably some clinics that do most of what they do is post-surgical, but most of what I do is orthopedic evaluations and treatment of everything from your ankle sprain to tendinopathies should be like your people know about tennis elbow, golfer's elbow, low back pain and we're kind of the first line of defense in those conditions. You may see your primary care then see the orthopedist, but oftentimes they're going to say, if you haven't tried conservative management with structured exercise, manual therapy, different interventions that we have with dry needling, whatever it might be, you need to start there and then ... Yeah.

Ben Smith (09:40):

Awesome. So Travis, so just obviously I'm working with you on the golf side, part of it in my head was here we are doing this podcast and you kind of look down a road and you hear a lot of advice about, geez, you got to stay mobile and you got to work on your balance and you got to work on just making sure you are a stronger version of yourself to allow yourself to stay independent as long as you possibly can in your life. But obviously picking up the phone to anybody or dropping an email can be a little intimidating because you don't know what to expect. So love to just hear about if somebody's contacting you and they go, "Hey, Travis, I'm reaching out to you. " What should someone expect at their first PT appointment? I'm reaching out and again, I'm probably am fearful a lot of things of maybe judgment.

(10:34):

I'm fearful of the state of where I am today. I guess if you're on the other side of this, I'm receiving somebody for the first time, what would they expect as terms of maybe what they could receive as the meeting you and what they would get in that first appointment?

Travis Deabay (10:53):

Yeah, no, that's a good question. It's easy sometimes for me to forget that that could be intimidating as something that I'm just doing every day, but it certainly could be. The first visit coming in is really do tell people, be in loose clothing that you can move around in because that's important. But the biggest part is the conversation to say, what's going on? What are you struggling with? How does that impact your daily life? What are your goals? And then really two, I think in terms of the intimidation portion of it or the anxiety around that, I always tell people, we need to make this fit in terms of the time commitment and the financial constraints are often the two obstacles. Sometimes it's totally covered by insurance, so we can knock one of those out, but oftentimes people nowadays in particular are dealing with high deductible plans or larger copays, co-insurances.

(11:45):

So we try to make it fit whatever is going to work for that particular individual. So it's really that conversation is the biggest part to make sure it's going to fit within your life. And the second part is the evaluation, seeing how do you move strength, range of motion, but trying to keep it as comfortable as possible because some people are coming in in quite a lot of pain while others aren't, they're just looking to address some little things that come up here and there.

Curtis Worcester (12:10):

I like that. Just sounds like a good way to just get to know each other because ultimately it is kind of a relationship that you're building with these individuals. So that's super helpful. I want to go back to maybe an angle I teed up in my previous question, which is the PT post-injury or post-surgery. I think that is probably one of the more common reasons we see people maybe seek out a physical therapist. And of course, correct me if I'm wrong there. I know we're talking about other reasons to seek you out, but certainly as we age may be recovering from a injury or surgery. So we have knee replacements, we have hip replacements, we have rotator cuff issues. I guess my question for you, Travis, is what role does physical therapy play in helping somebody then regain mobility and honestly confidence after these types of procedures?

Travis Deabay (13:02):

Well, yeah, for sure. I mean, confidence is a big part of it too. When we start off, it is all about for most of these surgeries, it is all about mobility and being able to regain, I think about mobility as range of motion in your joint, how well can you move that particular limb or your torso, whatever it might be. An example of a rotator cuff repair, those can be kind of long rehab processes and people don't often know that going into it how it's going to be, but for the first so many weeks, depending on your surgeon and the degree of the surgery, I'm just going to be moving your arm around, keeping it limber, keeping the fluid moving. Then it goes down to for a hip replacement, people are moving quite well sometimes don't even need a whole lot of PT. We're just going to end up then working more on strength and it varies so much.

(13:57):

I have sometimes more people after a hip replacement who are incredibly fit, strong, and active who then say, "How do I get back to the point where I feel comfortable swinging a driver as hard as I can or bending down to pick up my grandkids, doing yard work, whatever it might be. " And so sometimes I work with them even longer than the folks who are just pretty content doing their daily walk and moving around their house.

Ben Smith (14:22):

Yeah. Travis, it feels like then I got a mom right now who's scheduled to have hip replacement surgery in another, I don't know, week and a half or something. Yeah. And it's amazing to me because it feels like there might be a, this is just an observational change, but it feels like she's already been doing the PT work because she's strengthening and just even though yes, she has an injury that needs to be repaired and replaced, she's already been doing the strength training so that when I think post-surgery, when she goes back to doing PT, she's kind of already has all this muscle already built and it's maybe a faster recovery. Is that a change that has maybe been more recent? It sounded like to me that I would, again, someone that doesn't know, but that is like, "Hey, I get an injury, I have surgery, then I have the rehab and I have PT." But it sounds like there's maybe some more proactive nature that's been happening a litle bit more.

(15:16):

Agree, disagree?

Travis Deabay (15:17):

Yeah, I think there's both sides to that because they did definitely used to do a whole lot of prehab before say even ACL or reconstruction total knees and sometimes it's still needed to be able to make sure we have the best condition going in. But there were a number of research studies that showed that the outcomes weren't dramatically different. So then I think people stopped doing it so much, but then there's just a lot in our society. You have people who are super health conscious and those who maybe aren't so much and those who are more health conscious are getting in more now again as you're pointing out to get those exercises in, get familiar with them, build some strength, be able to go in as good a condition as possible.

Ben Smith (16:04):

Yeah, I look at that and go, it does make sense that maybe there's some better outcomes or what you just said is this isn't the first time she's ever done these movements and she's already been working on it and doing it and hopefully gets her back on her feet more quickly. But I want to ask a question a little bit different about chronic conditions,

Intro / Outro (16:27):

Managing

Ben Smith (16:27):

Chronic conditions through movement. And I know many retirees live with chronic conditions like arthritis, diabetes, heart disease and say chronic back pain. Can you just talk about the role of physical therapy here helping to manage these conditions, especially to reduce pain and limitations?

Travis Deabay (16:44):

Yeah, for sure. Arthritis is one that comes up in a daily conversation because I have a lot of people that come in and have already had imaging, shows that they have arthritis in their shoulder or their knee and sometimes they're a litle reluctant to even be in PT and say like, "Well, what are you going to really do for me? The arthritis isn't going to change." The answer there is that no, the imaging results are not going to change. Well, after we do PT, exercise, stretch, whatever we're going to do, go back and have that x-ray, it's going to look the same or you mean you're a year older now, so maybe it's even worse. But again, going back to research shows very objectively that people can get much better, not only in terms of their movement, strength, range of motion, but also in terms of their pain, even in the presence of that significant arthritis sometimes, which is where you can really get fooled based on what somebody looks like, what the root cause of their pain is, and then what the imaging shows.

(17:44):

And it's not as though imaging doesn't have a super high value and it's always nice to be able to look at it and marry the clinical presentation with the imaging results, but not always one for one in terms of how you can feel overall. So that is something that I have a daily conversation with people about and it's one that I try to point to research and say, "You don't have to take my word for this. Look at these massive studies that show people will get better." Not everybody. And that's why orthopedists have super long wait lists for joint replacements too. So we look at, you mentioned heart disease, that's a case where sometimes again, going back to Curtis's question about confidence, being able to grow in an exercise program while somebody like a physical therapist is monitoring vitals, keeping close eye on you, teaching you how to safely push yourself again and get stronger, more mobile.

(18:42):

And chronic low back pain, that's kind of right in our wheelhouse of something that I'm treating most of the time. That's a large percentage of our caseload. Gotcha.

Ben Smith (18:50):

Well, I want to ask another question, Travis. And you've done advanced training and functional movement screen and selective functional movement assessment. Again, I came to you through the Titleist Performance Institute side, which I'm sure sounds like it goes hand in hand here, but just for me going like, "Hey, there's things in my golf swing where it's like I feel like I wasn't able to move correctly to then get in a proper position." So to be able to assess those movements where the limitations are and then go, these are the exercises you need to do to then improve to allow yourself to get to these things. Can you talk a little bit about those systems? And again, maybe not golf specifically, but what the systems are and how they help you analyze someone's movement patterns so you can identify problems that may not necessarily be obvious, I guess to if maybe myself even just the, if I'm being assessed myself, that I wouldn't even know I'm limited in this way.

Travis Deabay (19:51):

Yeah, for sure. And it's actually the Titleist Performance Institute and SFMA are closely connected. Greg Cook had worked together with the folks at TPI to develop their overall assessment process. And what it is, is basically a way to look at global movement and movement patterns. For example, your ability to touch your toes. Previously the standard is, can you touch your toes? And if you can, good. If you can't, we need to stretch your hamstrings. And that's, I mean, the simplification, I'm sure there's a lot of great other evaluation techniques to be able to tease this out. But the SFMA would look at that and go, okay, he can't touch his toes, but why is that? Let's take that movement pattern. We have different quality measures on it to see how well is your upper back moving, how well is your lower back moving, your hips, your knees, your ankles, and be able to then break all of that down to the requisite movement patterns within each joint and say, "Where is this coming from?" And they then can point to more direct root causes of it and almost always is not tight hamstrings.

(21:01):

It's some other way in which you move, but it's easy to point to something like a tension in your hamstring kind of sensation when that's what people feel, but it's really because they can't shift their weight back or they don't have enough hip range of motion, that sort of thing. So it's basically a way to look at global movement patterns, squats, toe touch, backward bends, all of these things and then break it out into the different joints and other limiting factors. Hopefully that makes sense.

Curtis Worcester (21:26):

Yeah. Gotcha. No, that's great. I'm just sitting here thinking that, not to make this a commercial for you, Travis, but now I'm like, "Man, I might need to go here because I got Ben doing the Titleist stuff. I got other people I know doing

Travis Deabay (21:37):

It

Curtis Worcester (21:38):

Taking over my golf circles here, Travis." Sure, for sure. But no, I want to ask another question for you. I think we teased it in the very beginning, but we've had a few conversations with strength coaches or various gym owners on this show and not trying to pin you against strength training or anything like that because I think it's all more connected than even people realize, but we talk a lot about mobility and exercise. And again, the previous angles we've taken have been from a strength kind of training perspective. But I want to ask obviously from your perspective now as a physical therapist, what's the difference between rehabilitation focused movement work and general fitness training? What's the give and take there?

Travis Deabay (22:28):

Yeah, no, definitely there's a ton of overlap and you'll have more often than not, I would say people come to me and they're in pain. I do work in a hybrid model. I have folks who will come to me because they want to just move better. I'll have folks come to me because they've heard about the TPI and they want to work on things related to their golf game, but most people come to me because they're in pain. And so what I'm trying to do is help you get out of pain, help you just move better. And then typically my job will end there when you are feeling better, we've got you on a home exercise program, things you can keep going with. And I encourage so many folks then, please go continue this journey, use this as your launching point to go do some strength training, go to a gym.

(23:16):

I have several folks who I recommend people to all the time. I see a strength coach on a regular basis because it helps me so much. I learn from him and there's overlap there because I go see John Gonyea at Hybrid. He oftentimes is, or not oftentimes, is always looking at not just building strength, but how do we get people moving better?

Ben Smith (23:38):

Gotcha. Well, so you brought up something, Travis, about obviously people coming to you because they're in pain oftentimes. I think there's been a lot of conversation about pain treatment over the last maybe couple decades too and maybe chasing symptoms here. So again, a lot of people treat pain with medications, really short-term solutions. So if I just take more ibuprofen, I just take some more Tylenol, which obviously can just mask things, but talk about in terms of PT approach here differing in terms of addressing the underlying cause instead of just treating symptoms. Because I could see where there can be skepticism of like, "Hey, you made the pain go away, but did we really make the whole thing better?" So just talk about your approach there when you, hey, someone's coming to you to say, "I'm in pain and it's my lower back and that's where it's radiating and I'm feeling this.

(24:33):

" So how do you root those things out again, symptoms and treating pain?

Travis Deabay (24:38):

Yeah, so that's a good question. So we are going to hopefully be able to have some test retest measures in terms of your movement patterns. And that's where it comes back to how we use our assessment, which is the SFMA or another different assessment technique that I'll use to say, okay, your back hurts here, how do your hips move? And after we do an intervention, then how do your hips move? If we can pick up mobility in one direction, then we know our intervention is helping. Now our assessment technique is not hopefully just focused on that one area of pain, but looking at if it's your back, how do your hips move, how strong are you, what do your ankles look like? How does your big toe move and how that could impact your gait pattern and then throwing everything else off up the chain.

(25:28):

So people have a pretty good working understanding most of the time that we're a very interconnected system and how you breathe and hold your posture can be impacting everything up and down from your feet all the way up to your neck, but sometimes don't always have the ability to assess that well. So that's where we're trying to do that and root out those different things. And to your point, yeah, your pain has gone away. That can just happen over time, but how do we make sure this doesn't happen again? And that's where we're looking at, okay, we have improved these different movement metrics, which will give you the best chance for this to not come back again.

Ben Smith (26:05):

Gotcha.

(26:07):

I'm going to pick on myself here a little bit, Travis, and obviously we're going to talk a little bit about our relationship together, but I think it's helpful as a little bit of a case study here maybe for listeners that are out there. And again, I've mentioned that I came to you through, again, working on my golf game and the Titleist Performance Institute program. And I think what's interesting, as you said, is I think because I've had a lot of mobility challenges being working at a desk and sitting with people and just sitting in a chair, I think for my entire career or in a car going to people to sit in a chair, it feels like that's the focus of my life has been doing that vocation. So it then creates maybe mobility issues where I feel like I've had very poor balance and all of a sudden I get into my golf swing and I'm like, I'm getting on my toes and then I'm falling forward as I go to release the golf club or my rotation, I'm maybe too tight to baby.

(27:12):

So it's like all these mobility, rotation, balance, which to me was a lot of, I think the issues that I hear people talk about as they say, "Hey, I'm 65, 75, 85, 95 and I'm dealing with balance issues where I'm struggling when I go upstairs or I can't really rotate and reach for things." So can you talk a little bit about maybe explaining movement for sports, how it really overlaps with improving function in everyday life and what you see there?

Travis Deabay (27:43):

For sure. Yeah. I mean, you brought up balance too as one of the key points and something that I'm always checking in folks and that's been one of the biggest eye-openers when I started a few years ago working with folks through this TPI assessment and people who are coming into me who were not actively in pain. And the biggest takeaway from the first eight to 10 people I worked with was recognizing that they did have balance issues and that was so eye-opening to them to say, I'm glad that we did this to now know I have something I need to work on because almost everybody in their life has witnessed parents or grandparents getting older and seeing them losing their balance and falling and having devastating injuries and then saying like, "Man, how can I not have that happen to me? " And there's no way to prevent our balance getting worse as we get older entirely.

(28:38):

I mean, your 20-year-old is always going to have better balance than your 90-year-old, but I certainly see a lot of 90-year-olds who have put some time and effort into exercise and working on their balance who have incredible balance. And so we know that that is very possible and it's just a matter of maybe being aware of it and then being able to work on it in terms of other impairments everyday life so much of people's shoulder pain ends up being that they don't have yet is related to not being able to move well through their upper back and being able to extend and rotate in different areas. Back pain, again, being related so much to hip mobility, which is a problem probably largely and in some part due to sitting so much. Yeah.

Ben Smith (29:23):

And I'll add, Travis, is I've gone through a couple rounds of really extended lessons with golf coaches and I think the first time where I was really getting into golf and after we established this business and got the CFA designation and I did all these things and I was like, "Hey, this is my time and now I'm going to go work on golf and get better there because I want to enjoy it. " I think I spent a lot of time working on a golf swing, which I did not have the strength to do. I think what was really clear to me, I'm working on things and I'm complaining like I'm getting all of my left side and my ankle is going over the left side of my foot.

(30:07):

And boy, that was just stretching ligaments on my ankle as I was trying to shift weight to move towards the target and I'm just not able to move and I'm hurting myself as I'm trying to swing the golf club properly to instruction. I was able to do that and take instruction and translate that into a golf swing in the short term, but then I receded back to old habits because it was painful to do that swing and I didn't have the strength built in all the key areas to then maintain all the instruction I got. So then I went back to bad habits

(30:41):

And things that were not painful, which then undid a lot of the key lessons I think I had learned along the way, which now that I have yourself and I'm working with Chad Curley at SimCity here in Bangor and the two of you combined, it's like I'm doing strength training with you and the mobility piece and then I'm getting proper instruction as I'm getting all these core pieces. So now it feels like to me it's like I got this recipe and it's sustainable and I can do something with it, but I kind of look backwards as like, if I had done this a little bit differently, if I had maybe focused as much on the strength training and the mobility and finding limitations, I would've been able to do a better job with the money I was paying one on the lesson side and gotten to the result I wanted more quickly.

(31:29):

So that's a personal highlight I just want to get your reaction to, but I think that was something of a lesson of me is I should have done this way earlier.

Travis Deabay (31:37):

Oh, for sure. Yeah. Yeah. I mean you mentioned the strength piece of it is so important for so many people and not just in their golf swing, but as you mentioned, how does that go to everyday life, just being able to bend down and pick things up the way they should be able to and didn't know. But then looking at the golf swing and how different strength or mobility limitations are affecting their ability to properly get into the position they want to and not understanding why can't I do that or why can't I consistently do that? And sometimes it is just a motor pattern issue that you've got to go see Chad to help work on how am I feeling that position. Sometimes he can be really wanting you to get to a certain position, but you don't have the shoulder mobility to get there.

Curtis Worcester (32:26):

Exactly. All right. Enough about Ben getting better at golf. We're moving on. I do want to actually build on that a little bit and maybe in not just the golf sense, but something that you both have just talked about a litle bit there was balance and vestibular therapy is something that I think we want to talk about a little bit. So again, something that comes up I think that Ben and I see in our day-to-day with people as they age. Travis, I know you just said it, balance is a big one and even just dizziness, things like that. So I have kind of a two-part question for you, I guess. So the first part is can you just explain to us and our listeners what vestibular therapy is? And then the back half of that is how can PT help people with these symptoms?

Travis Deabay (33:13):

For sure. Yeah. So the first thing about dizziness that I always tell people when they start talking to me about it is if this is not something you're very familiar with in terms of why you're having those symptoms, go get checked out by your doctor because you have much more dangerous conditions that need to be assessed there. But in terms of the physical therapy aspect of it, there's a few different main conditions we treat in physical therapy. The most commonly known is when you have these little crystals that can get dislodged from where they should be, they help us to detect gravity. And when they end up in the semicircular canals, they start contacting hair cells and basically telling you you're moving when in fact you're not moving and people get horrifically dizzy when this happens and they get what's called true vertigo. So we have these Epley maneuvers and a few other different techniques that can very quickly get people out of that state.

(34:07):

I see folks on a very regular basis for that. It's very satisfying to treat because it's one of the conditions that we can have people leave and they don't always feel great then, but then the next day they're like, "Ah, I finally feel better." The other main thing is that as we age sometimes one portion of our balanced system, whether it's our eyes, our inner ears or vestibular system or our joint proprioceptive sense starts to decline. And then our brain is getting mixed messages. You may be getting signal from your eyes that you're moving at a certain rate, but your inner ears are not keeping up at the same degree that they were before. So it's like being on a boat when you get seasick, that your ears are telling you you're moving and your eyes are telling you you're knots. They tell you to look at their eyes and that sort of thing.

(34:52):

So what we try to do then in physical therapy, long answer here, but is to try to get people to then have exercises that will teach their brain how to marry all of those systems back together again and get those signals or interpret those signals in the correct manner.

Ben Smith (35:10):

Wow, gotcha. Yeah, because I'm thinking about, I got family members that kind of suffer from that a litle bit and I can see where that's because it's like things like going upstairs and they're at a sporting event and they're going up the bleachers and all of a sudden their eyes are telling them one thing about the depth perception and it's not really, and then they're feeling faint and dizzy and they need to brace themselves. Easy.

Travis Deabay (35:35):

Yeah.

Ben Smith (35:35):

Yeah. And it is very alarming because I think they're like, "I feel fine, but all of a sudden I got a sense of dizziness and everything looked the same and I didn't think it was as far. And then I went to go lean and grab a seat and it was way further than I thought and it looks really alarming to everybody.

Travis Deabay (35:52):

Yeah. And that's one condition too where it's much easier if you start to recognize that happening and get in. And these are usually quick plans of care in a sense where people are coming in, here we assess, this is what we want to start working on. Take these drills and work on them for three minutes a day for the next couple of weeks, come back and se me again, just a few repeated visits and people are usually feeling a ton better. Wait until it's gone on for 10 years and you really have a ton of balance issues. It's just harder to treat at that point.

Ben Smith (36:24):

Gotcha. I want to ask about to what you just said actually staying proactive versus maybe waiting for injury because I know a lot of people just wait until something hurts before they need help. So they're like, well, until it's really, really bad and I can't take it anymore, then I'll go see somebody like Travis and see if I can get this taken care of. So maybe just in terms of your practice and maybe what you're seeing from the timeline too, what are you seeing in terms of now people being proactive on things and saying, Hey, I want to now do something about this. I'm starting to see some things versus they're waiting towards the catastrophic end of things and now I'm in tremendous pain and I just couldn't take it anymore. Now I got to come see you and what can you do for me?

(37:11):

Talk about, I guess I'm interested in terms of maybe speed of recovery of things when things are a little bit alarming versus it's now it feels very disastrous because I'm in tremendous pain and maybe the recovery pattern from those.

Travis Deabay (37:26):

Yeah, for sure. A couple main things there, you're right. And another good point to bring up is that Maine, we're very fortunate as physical therapists to have direct access. So that means you don't have to go for almost all insurance plans. Some insurance plans will still require to get a physician's referral, but for most people, you can just contact us directly. You don't have to go see your PCP if you know you're having just a musculoskeletal issue. And so in that way, we have a lot of people who will come in very proactively. They start to feel some things coming up, they know it starts to limit whatever their daily life activity is and they're calling us right up to get in much, much easier to treat in that way than when it's been going on for six months, couple years. We are seeing too more people that are ultra health conscientious and they're calling us up just to look at something that they is not feeling right.

(38:22):

Some of the issue that you run into there is if you're not, unfortunately with insurance companies, if you're not having something that's limited in terms of your daily life, they don't really want to cover that. The cost is not exorbitant so people will just choose to come in and pay and see us to try to correct problems before they become big problems.

Curtis Worcester (38:44):

Yeah, no, that's super helpful. And I think you can translate that across a lot of things of being proactive versus waiting for a catastrophic injury or event. So that all makes sense there. And I think this entire conversation, Travis, has been really helpful for us and hopefully our listeners. And I do have a closing question for you. It's going to be a little bit different than the ones we've been asking. So that's where my transition is coming here. So I guess first I'll just thank you again for coming on our show and sharing your expertise and hopefully breaking down that barrier I think we opened with of the intimidation of people calling up someone like yourself to go make sure they're aging and staying mobile in the best ways possible. But my last question for you, Travis, so again, the name of our show were the Retirement Success in Maine podcast.

(39:36):

We're just trying to help people find that successful retirement. So I have to ask you a retirement question now. So the question is, how are you going to find your personal retirement success when you get to that point? What does that look like to you, you think?

Travis Deabay (39:51):

Yeah, I like this because it's something that I do talk to so many folks about on a regular basis just because I work with so many people who are at or very near retirement and I think I've had the privilege of working with so many people around that age to show me what that can look like on both sides of the spectrum. And so my answer here is not just because I'm a physical therapist and that's what this podcast is about, but honestly, this is what I see so often that it's shaping my view that being healthy and trying to put myself in the best position to be healthy because it's just so many who were able to get to that monetary level where they could comfortably retire but maybe hadn't taken as good a care of themselves. Or I mean, there's just so many things that are out of your control, but you control the factors you can or folks that simply waited too long to retire and then said, "Man, I wish that I hadn't waited because now physically I'm not able to do all those things that I thought I was going to be able to do once I did retire." So that to me, I mean, I try to do the best I can to keep myself healthy and try to do the best I can to save money so that I'm not having to wait to the point where I'm not too old to enjoy what I've done and I'm healthy enough to do it.

(41:13):

So I guess there's a lot of other things I can talk about there, but that's the main one. Yeah.

Curtis Worcester (41:18):

That's a great answer. I really like

Ben Smith (41:19):

It. Yeah. Well, Travis, thanks for coming on our show. We really appreciate your time today. I know we'll put all the links to DBA Physical Therapy on our site and we'll back link there too. But again, appreciate you coming on and just sharing your expertise today. Thank you.

Travis Deabay (41:38):

Awesome. Thanks for having me. Appreciate it.

Ben Smith (41:40):

Yeah, you got it.

Curtis Worcester (41:41):

So of course, Ben, that was another great conversation to have. I think it really reinforced something that I know we talk about a lot on this show, but retirement and retirement success isn't always about just the money factor. That's

Ben Smith (41:55):

Right, exactly. You can have the perfect financial plan, but if your body is not cooperating, it can seriously limit the things you want to do.

Curtis Worcester (42:02):

Absolutely. So again, just a huge thank you to Dr. Travis Deabay for joining us today. I know that was a fun conversation because I know we both personally kind of know him there, but it was really informative to hear from him as well. And hopefully everyone listening can learn a little bit about staying active and mobility and healthy.

Ben Smith (42:21):

Yeah. And again, I know I was trying to ... I had some of my experience in there, but I think the highlighted lesson is, look, anybody at any age really should be focusing these things. And I think even just these small muscle things, you don't have to be ... They're all Schwarzeneggers of the world. You can certainly just have the micro muscles be more in tune, keep your balance intact, are just going to serve us all well as I think we age. So if you want to get in contact with Travis or just want to check out his website, we will have that all linked, including the Titleist Performance Institute piece. So if you have a golf slant that you're interested in, he can help with that. And he's one of the very few in the state of Maine that's doing it. But you can go to our website, blog.guidancepointllc.com/123, not just a Michael Jackson song, but Jackson five.

(43:18):

It's also episode 123. Wow. So you can go to one, two, three there and you can see more of our links there. Get over to Travis and check it out. So we thank you all for listening to our show today, The Time Success Main podcast, and we'll catch you next time.

Outro (43:36):

Ladies and gentlemen, you've just listened to an information filled episode of the Retirement Success in Maine Podcast. While this show is about finding more ways to improve your retirement happiness, Guidance Point Advisor's mission is to help our clients create a fulfilling retirement. We do financial planning so that people can enjoy retirement and align their monetary resources to their goals. If you're wondering about your own personal success, we invite you to reach out to us to schedule a 45-minute listening session. Our advisors will have a conversation with you about your goals, your frustrations, and your problems. Make sure you check out GuidancePoint advisors on our blog, Facebook, and LinkedIn, and you can always check out more episodes of this podcast on iTunes and Spotify. And of course, keep on finding your retirement success.