Neck & Shoulder Knots
Hey there! I’m Dr. David, Physical Therapist from El Paso Manual Physical Therapy.
I’m Dr. David, Physical Therapist from El Paso Manual Physical Therapy.
I was just doing some paperwork on the computer right now & answering some emails from some current patients of mine.
I was getting a little knot developing right here in my neck and shoulder area.
This is the space between my shoulder and my neck.
I exercise and I do some things to make sure I take care of it, but here’s one of the tricks that I use because I have to work at the desk quite a bit, and I know many of you out there probably have desk jobs where you’re working at the computer or maybe doing like paperwork at a desk.
Here’s a tip that you can use to help prevent those knots from getting worse.
You’ll even help prevent theĀ knots to begin with, and be able to get through the end of the day so that you’re not just flared up by the end of the day.
Those knots might just be killing you, and you just want to go take some pain medication or get a massage or something, so you can get to the end of the day and feel pretty good.
First, make sure that your computer and your desk is set up so that you can put your arms on the desk like this and actually shove your shoulders up just a little bit. And it’s okay to slouch from time to time so that you can move your shoulders up. You see how when I lean forward a little bit, it raises my shoulder?
And it’s okay to slouch from time to time so that you can move your shoulders up. You see how when I lean forward a little bit, it raises my shoulder?
You see how when I lean forward a little bit, it raises my shoulder? Well that takes some tension off this area.
Part of the problem in getting these knots is that if I’m not supported from here pushing my arms up, the weight of my arm pulls down on these muscles right here, and it starts to stretch them out over time.
Now, it’s no big deal for a little while, 15, 20 minutes, especially if you don’t have a problem going on. But let the hours pass by. Say an hour or two, three, four hours, eight hours passes by, and this is hanging down, this is going to start to get really, really tight, and you can start to develop some spots in the muscle where it bulges up, and you create a knot.
Say an hour or two, three, four hours…. eight hours pass by, and this is hanging down, this is going to start to get really, really tight, and you can start to develop some spots in the muscle where it bulges up, and you create a knot.
Another thing that can be setting up a knot … Well, let me back up a little bit.
Have you ever had that type of knot that is hard?
You dig in here, and it just feels like rock solid, like it might even be a bone. Well, sometimes it is a bone. Let me show you what I mean on my skeleton here. So this is the shoulder right here, collarbone.
Well, sometimes it is a bone!
Let me show you what I mean on my skeleton. So this is the shoulder right here, collarbone.
So this is the shoulder right here, collarbone.
The first rib is right here, and your second rib is right here. Those ribs can actually pop up and contribute to that knot.
You might actually have a bone from one of these ribs sticking out.
They’re about right here, and they can pop up a little bit, and they can be really painful.
It can be really tender. It can feel really hard as well.
And that’s something that you’re not going to massage out. It’s a shifted bone up in the neck and shoulder area, and just rubbing it might make it feel better temporarily, but what needs to happen is we need to find a solution to get that rib to sink back down.
It’s a shifted bone up in the neck and shoulder area, and just rubbing it might make it feel better temporarily, but what needs to happen is we need to find a solution to get that rib to sink back down.
There’s a ton of reasons why those ribs can pop up. That’s something that we look at here, we talk to clients about all the time. And we can get them to come back down and settle down so that they’re not a recurring problem.
That’s something that we look at here, we talk to clients about all the time. And we can get them to come back down and settle down so that they’re not a recurring problem.
And we can get them to come back down and settle down so that they’re not a recurring problem.
But it’s just something I wanted to tell you about today. Now, if you work at a desk, make sure, just to review, your arms are supported like this, or if you have a chair that has some armrests, especially if they’re adjustable, make sure those armrests push your shoulders up a little bit from your elbow down here.
Now, if you work at a desk, make sure, just to review, your arms are supported like this, or if you have a chair that has some armrests, especially if they’re adjustable, make sure those armrests push your shoulders up a little bit from your elbow down here.
I hope this helps you out.
I hope that if you have a desk job, you’re not running into those shoulder knots.
If you do have knots in your neck and shoulders, try these things.
And if you’re still getting problems, you might have a shifted rib, or there could be some other problem.
There’s nerve problems that happen up there too.
Sometimes there are muscular problems that need a specialist’s help as well.
Give us a call. Reach out to us. Contact us on Facebook.
Contact us online, and we’d love to help you out and talk to you more about it.
Thanks so much. Have a wonderful day.
How Acupuncture Can Help With Fertility Problems ā with Adrianne Ortega
/in Podcast/by dmiddaughDr. David
Hello El Paso! This is Dr. David physical therapist from El Paso Manual Physical Therapy. Welcome to the show. I've got Adrianne Ortega here, expert acupuncturist she's the best in the southwest, definitely the best in El Paso. And we're going to be talking about fertility today. That's one of her big specialties. So, I'll let Adrianne tell you all about that. But first let's hear about Adrianne. So, Adrianne, where you from?
Adrianne OrtegaĀ
I'm from here, El Paso, Texas. I actually graduated from high school like, you don't have to say how many years ago, but it was quite a few years ago. Like there was a big reunion last year. So yeah, I went to Montwood, I then went to St. Mary's University in San Antonio and then I transferred up to Weber State University in Utah. Went out of state for a little bit. So, graduated from there and then made my way back to Texas, and in particular to Austin, Texas, and that's where I went to AOMA Graduate School of Integrative Medicine for what I currently doing, you know, I'm an acupuncturist, so I went there for my degree in traditional Chinese medicine.
Dr. David
That's so cool. And you know, one of the interesting stories that I remember when I first met Adrianne and learned about her acupuncture schools. I went to school in Austin as well. I lived in Austin for a long time. And there was a coffee shop around the corner. I don't remember the name anymore, but from the acupuncture school that you went to, and I would always pass by that school and think, oh, that's neat. They have an acupuncture school right here in Austin. And, and so when Adrianne brought it up, I was like, I know where it is, I know that school. I've seen it. I've looked through the windows. Yeah, that's pretty cool. So anyways, you've got your practice here in El Paso. So, tell us about it. What's the name? Where's it at? How long has it been going?
Adrianne OrtegaĀ
Yeah, um, it's on the acupuncture and here located in central El Paso 3330 Purshing. This will be our sixth year. It's gone by really quick. And yes, so we're here on the corner of Luna and Purshing.
Dr. David
Awesome. That's, that's so cool. And so, what's something very unique about your practice?
Adrianne OrtegaĀ
Well, I think something that's really unique about my practice is that I basically fell in love with my practice and practicing medicine. And I think the other thing that's really unique and led me to this medicine is because I feel like there is a very personal quality to the medicine. It's not like per se a series of tests someone, okay, you check off this box. And that's means that that's how the treatments going to go. I really like this medicine because you can really tailor it to each person that walks in the door. So that's what I try to do here. At Alma Acupuncture, I really try to tailor what I do in my medicine for each person. It's not like a one size fits all. It's really nice that I can really make it for every person that walks in because every person is unique. Right? So that's the way I try to treat them with treatment.
Dr. David
Yeah, I've seen your practice. You take your time and you make sure you know everything that's going on you asked tons of questions. So, I've I can vouch for Adrianne, she really does make it extremely personal. Well, if you don't mind, can we talk about fertility some more?
Adrianne OrtegaĀ
Oh, absolutely. For sure.
Dr. David
I know it's one of your favorite topics. So, fertility Tell us about it. What is it exactly and what got you interested in it?
Adrianne OrtegaĀ
Well, I got really interested in it. Because in I was about, I think I was 25-26 years old. I had just moved to Austin. And I kind of just kind of hit a wall immune system wise, I started getting really sick really often had never had that issue. And all of a sudden, I was just getting sick all the time feeling really lethargic. Lots of fatigue, which for 25-26-year-old, that's just not, it's not normal.
So, I would go to doctors, and I didn't get a lot of answers. They would do tests and more tests and other panel here and another panel there and they're like, āno, everything's fineā. Like, no, I'm not buying it, this is not okay to feel so exhausted and depleted all the time. And inadvertently, because of that, pretty intense fatigue. I started having some other, nothing serious, but some hormonal issues. So, I started seeking answers. I was like, Okay, well, I'm not getting very many answers through my gynecologist or my PCP and other specialists in the western medicine.
So, I started exploring going to a chiropractor, and I started going to a naturopath and this, and then someone recommended to go to acupuncture was like, āOh, I went to an acupuncturist a couple years ago, sure. I'm familiar with acupuncture, fairly familiar.ā I'd gone, for maybe 6-12 treatments.
So, like, okay, I'll go explore this and they were like, Oh, we should go see, Jen-Jen. I was like, oh, okay, I'm going to go see Jen-Jen. I was given her card. And so, I went on this path of healing and I started feeling better.
I just started feeling better. I went to my appointments, I started making herbs that I was drinking these powders. I don't know what I was drinking, but I knew that I was feeling better and I was feeling different. So, even though I didn't know the science or my diagnosis per se, I just knew that I was feeling better and I just kind of started falling in love with it.
So, from there, my practitioner Jen-Jen actually ended up being a professor that my grad school that specialize in gynecology had no idea I had no idea that she specialized in gynecology. All I knew is that she was making me feel better. I all I knew was that I was less sick, and my hormone issues were much more controlled, and I had more energy. That's all I knew is how I was feeling and that she helped me.
Dr. David
Wow. So, it was Jen-Jen that itās kind of sparked your interest in the in the fertility field and gynecology more specifically?
Adrianne OrtegaĀ
A little bit? Yeah, for sure. I started getting really interested into like, Oh, well, let me start reading more about you know, I started reading more books about women's health. And then I shared the learning about different herbs, and I started learning more about what was going on damn parts of my cycle. Like I really started becoming a student. Before I even went to grad school. I was kind of just like, delving into the female body. And I was like, Oh, yeah, it was it was it was quite the process, but I definitely learned a lot about myself.
Dr. David
So how I mean I'm just so that everybody is kind of on the same page who might be listening to this podcast, how big of a deal is it to see like, how many people are actually having you know, gynecological problems or fertility problems? That, that end up going to go to a seeking an acupuncturist help.
Adrianne OrtegaĀ
Are you seeing like how many women need to make sure? How many of my patients are women's health? Are you saying like how many women and the general population have these issues?
Dr. David
Yea, the general population, like how many people are going to their typical gynecologist, to the mainstream, and then arenāt getting helped and really could be seeing somebody like you?
Adrianne OrtegaĀ
Absolutely. I mean, a lot of people. I mean, if you go to let's just say a patient is diagnosed with dysmenorrhea, very basic dysmenorrhea is painful menstruation. That is awful, because that's happening every single month to a woman. It's a big population, about 20-30% of women suffer from dysmenorrhea. Now, the only treatment that Western medicine at this time has is birth control pills. That's the number one. And the second thing that they give are muscle relaxants. Now, women like to go work and like to take care of their families and you know, live from day to day.
Now, if you're taking muscle relaxant that's going to be really intense, and you're going to have all these other side effects. The other thing women like to do, is eventually, not everybody, they want to get pregnant. So, if they're on the birth control pill, and they're for painful menstruation, but at some point, in the childbearing age, you want to have a child, then they're kind of stuck between a rock and a hard place. And that's kind of where alternative therapies, you know, are really helpful, like acupuncture.
Dr. David
I you know, I guess been a been a male, I'm not 100% familiar with it, but you know, being the medical field, you know, knowing you, of course, being married and all that, I hear about all the problems that lady's run into, but I guess I don't have that. You know that that personal experience.
Adrianne OrtegaĀ
But you know, you go to a barbecue and you heard so and so they want a second child. Don't you hear those stories? Or, oh, so and so's wife couldn't make it. She wasn't feeling well, because right now, we all know, I mean, we may not know someone directly, but you know, someone indirectly, if not in your circle that's suffering from some kind of woman's health issue.
Dr. David
So, is it being the infertility problem, usually that in other words, if somebody can't get pregnant or they don't want to get pregnant, there's a reason for that is because there may be on birth control to avoid the painful menstruation?
Unknown SpeakerĀ
I mean, that can happen sometimes. Right? Some other reasons and what can lead them into my office also, because then, let's just say they got birth control pills, since they're 14. Now they walk in my door. 16 years later, they've been on birth control for 16 Yours. They have not had any normal hormonal regulation for all those years, and let's just say they've been off with a pill for two years. They're like, Oh, I haven't had a pill in two years. I mean, how I had a period in two years. That's a problem.
Dr. David
So, there's people that have been on birth control, for 10-15 plus years, then get off birth control, and still don't have a period.
Adrianne OrtegaĀ
Sometimes that happens, but that happens often. I almost see it a couple times a month. Well, I'll have, and it's called, it's actually has a name. It's called birth control. amenorrhea. It's lack of a menstrual administration, due to birth control. Now, they weren't doing anything wrong. They were they went to the doctor, their parents are going to the doctor and they needed help, because you know, she was missing school, or she was missing soccer, or she was missing. She just wanted to feel better. So, the natural solution Western medicine provides is getting on birth control. That's the path of least resistance. Right? But now they're walking in 30-35 years old now 15-20 years later, and they want to conceive and they're having a hard time.
Dr. David
Wow. Well, this is good. Are there any other very common reasons that people have fertility problems? So, you mentioned you know, there aren't they may be on birth control for a long time. You mentioned they had painful cycles. Are there any other big ones that that come to mind that people might often come in for fertility?
Adrianne OrtegaĀ
Sure, for sure. There's PCOS, which is it's called polycystic ovarian syndrome. And it's actually an endocrine response. It's an endocrine dysregulation, and that's about 10% of the population. Of women have that. Now what happens there is that their period gets very irregular. It's just kind of just all over the place. It's like it'll come every 35 days and only like 60 days. So that's one big reason why people come into my office.
Now what happens there because a PCOS that's also really hard, is if someone suffers from PCOS and they are able to conceive, they have like a kind of like a 15% chance they'll actually miscarry. So, I mean, that always exists, right? One of our four pregnancies end in miscarriage, but that goes up even more if they had the diagnosis of PCOC.
The same goes for endometriosis. Endometriosis has to be more of the population. It's like 15 to 20% of the population. Women suffer from endometriosis and they have really painful periods where they're having to go to the ER, and causing other endocrine issues and, and implantation issues when they do conceive, and it makes them about 20% more likely to also have miscarry.
Dr. David
Oh my gosh this is so good, I'm so glad again being a guy I'm playing the dumb the dumb guy card here you know my specialty I'm in a completely different field as far as like section of the health field. I'm in you know musculoskeletal stuff but I'm learning so much just listen listening about this because I guess in my mind, with my dumb guy brain, I think that the lady organs are like, genetically, you know from birth they've had problems or there's some issue that happened that there's like some damage to an organ, but from what you're saying that's not really the case. It's just that they've been on say birth control for too long or they've got some other hormonal problem and that's what you help them with through treatments. So, this is so cool. It's awesome.
Adrianne OrtegaĀ
I kind of want to, is it okay if I touch on maybe... I also treat male factor fertility.
Dr. David
Yeah, let's talk about,
Adrianne OrtegaĀ
Let's really talk about that, because a lot of good research is coming out that male factor is a serious factor. And to be perfectly honest, I would say about 80% of the couples that do come in actually have male factor and female factor. Ā In my office, in my office, right? It's kind of crazy. Like, I think that's what is a little bit different about me and that's why you want to find an acupuncturist that specializes in fertility, because I asked my couples to bring in their labs because I want to see her lab-work and the male lab-work.
Dr. David
That's going to be so relieving for the lady in the relationship to be like, it's not just me, it's you too. And, you know, we need to fix this problem on both sides of the relationship so that we can start a family or continue.
Adrianne OrtegaĀ
I mean, it's important to look at both because it takes two people to make this other person, right. So yeah, so I look at storm analysis very, very often. And I actually am seeing a remarkable decline in quality in quantity and count. I mean, I have 30-year-old coming in, and their analysis are comparable to someone in their 50s.
It's our lives, our lives are really intense. We work a little too hard or you drink too much coffee, we drink too much alcohol or drinking too much sodas, right? And not that it's like that for every everybody. But if you put all of those really intense things together, it's also causing some hormonal dysregulation for the men, and they've even did a huge study in Britain last year, and that sperm counts, just the count, not the quality, just the count has been cut by half since the 20s.
Dr. David
Oh my gosh. It's all the stuff in our, in our diets
Adrianne OrtegaĀ
It's the lack of, you know, vitamins and minerals in our diets. And it's the lack of vitamins and minerals in the soil and maybe not hydrating enough and not sleeping well. And so, it's a lot of things.
Dr. David
Wow, wow, this is so cool. I'm learning so much, Adrianne, thank you so much for sharing all this. So, I think you've covered why you're an expert in fertility. For me, you're definitely the person I'm going to go to if I ever have someone who has problems, or myself of course. So why should people come and see you if they have a fertility problem? What's like the main thing? Is there anybody else in town that does or to do or is what's different about you?
Adrianne OrtegaĀ
What's different about me is that I'm a fellow of aborn and a form that American Board of Oriental Reproductive Medicine. Now why that's a little bit different is because I know and I study as much as they can, the current research that's being done on male factor infertility seminalysis, you know, the newest developments on PCOS and hormonal dysregulation, endometriosis.
So, whenever I went, and I sat for my board exam, I mean, the board exam actually was about 75% Western medicine. So, I can read labs, like very comparable to like a reproductive endocrinologist, like I didn't know what they're talking about and why they are going to reproductive endocrinologist.
So, you know, I not only help people, families that are trying to conceive naturally, but I also help people that, you know, have to go the IVF route and invitro route. Or they have to do AUI or, you know, there's one more because of so many issues PCOS and endometriosis versus male factor or even a history of cancer. Right? They have to do IVF right.
So, then I can help support them in that fertility process. So that's what makes me different and basically 90% of my continuing education that I take every year, that's required to be a member of the board. Um, you know, it's in women's health.
Dr. David
So that's in addition to your general acupuncture training.
Adrianne OrtegaĀ
Yes, very much so.
Dr. David
So, you went to college, you got your bachelor's degree, then you went to your masters, and then you went to acupuncture school. And so, you're, that's already putting you in an acupuncturist. And then you did a specialist training in the in the women's health stuff?
Adrianne OrtegaĀ
Right and I passed my board exam which I studied.
Dr. David
Gosh, yeah, that's a lot of school.
Adrianne OrtegaĀ
Itās a lot of school. That board exam is no joke.
Dr. David
Well, so that's really good information. When somebody comes to you for treatment. So, I think one of the burning questions everybody has I know whenever I recommend you to people, they're like, is acupuncture going to hurt? And I tell them because I've had it myself. You know, you've worked on me before, and does not hurt at all from it from my experience. But what what's your description or what do you tell people about what you do with the needles?
Adrianne OrtegaĀ
Yeah, so with the acupuncture, normal sensations are a slight prick, heaviness, pressure, it might get warm in the area because increasing blood flow. But that's about it. In my in my professional opinion, it shouldn't be painful. Every once in a while. If someone comes in with pretty intense carpal tunnel syndrome, right? It's really inflamed. It can be a little tender. But should it be stabbing and painful? In my professional opinion? Absolutely not. Then maybe it's time to go see someone else.
Dr. David
I've had it done and it literally feels like pressure. It doesn't. It's maybe a tiny little poke. I say comparable to like a mosquito bite. I think I've actually had mosquitoes that had bitten me that had been more painful than an acupuncture needle.
Adrianne OrtegaĀ
I would definitely agree.
Dr. David
I'm serious. Adrianne's touch is so gentle, or I remember the first time she did it I and I'm just to give you guys a backstory. I'm terrified of needles. I've passed out several times I've had my blood drawn. Of course, those are big giant needles in order to get blood out, but the acupuncture needles are really thin. And it feels like just pressure and it's it was really painless. I was when I remember seen a picture because he took a picture, I wanted to see ask her to. And I was like all those needles were in my bag. No way. I didn't feel them. That's nuts. So, it was pretty good. What else do you do besides the acupuncture needling, and all those other things you do here in house.
Adrianne OrtegaĀ
Um, so I recommend supplements and I recommend Chinese herbs and other you know, lifestyle, dietary alterations. If someone that has PCOS I tell them, they should do this, should eat this, not thatā¦ that kind of thing. So, and then now, especially for certain, I have a patient that comes in and has a history of miscarrying for example, and repeated pregnancy loss, then I really want to make sure that that's not going to happen again at the 10th week. So, when I write up herbal prescription. And we make it here and we encapsulate it, and we put it in capsules for them.
Dr. David
Oh, that's cool. So, you guys actually put the herbs and the pills?
Adrianne OrtegaĀ
Yeah, like I make it specifically for them. Another thing is I have this other patient she can't get a formal diagnosis about what's going on with her. She doesn't clot fast enough. So postpartum we helped her to prevent her that she would bleed too much. Well, so I made her a formula for that.
Dr. David
Wow. Are people coming to you and leaving their other doctors, or are they seeing them alongside you?
Adrianne OrtegaĀ
Both. I feel like both, which I'm happy to do. I mean, actually, some other doctors are referring them to me now. I would I get I get referrals from all of the doctors that do IVF anyway, I get referrals from them now.
But are they leaving them? Sometimes they take a break, but they just need to kind of leave Western medicine for a little bit, take a break, and kind of recuperate and make that mind body connection and spirit connection again. Unfortunately, sometimes Western medicine and kind of keep that out. So, it's nice for them to come over here and reconnect with their bodies and their spirit. And then I refer out and I want them to get tested, because there's, it gives me a broader perspective about what's really going on. So, it's a little bit of both, really, so and I think that's, that is what's different than me.
I don't think there's just one way and that's the best way I think everybody has their journey in healing. And I'm just happy to meet them where they are and help them and support them in that process. If they are needing support and help somewhere else, then we'll help you find that somewhere else, you know, whether that's what that reproductive endocrinologist or he go talk to a therapist that we have referrals for that.
Dr. David
Cool, awesome. So when should somebody in El Paso reach out to you like what problems should they have? You know, what signs should they be looking for? At what point should they say I need to go to Alma Acupuncture and talk to Adrianne because I have this, this and that or I'm in this situation?
Adrianne OrtegaĀ
Well, if we're talking about fertility, and someone's trying to conceive, at any age, I say if there's no success in six months com e in.
Dr. David
So, they have been trying for six months, nothing's happening.
Adrianne OrtegaĀ
I know some doctors really pushed for a year, and I just I feel like my patients wanted to be pregnant three months ago. So, come in sooner than later. I have never met anyone that's like, Oh, I can't I you know, they all come in and we're like, oh, Dr. So, and So told me to come in six months ago, I should have come in sooner. Or my girlfriend told me let you know three months ago I should have come in.
So, I don't really have anyone that's like, Oh, I shouldn't really come in. They're always like, oh, why didn't I come earlier? Often that's what happens. And you know, if they have male factor, if they're going to do IVF the donor cycle like for sure you need to invest because you're investing a lot of time and money. You need to, you need to come to acupuncture because it increases your chances of conception by two-fold, which is pretty amazing.
And also, if you know if you have other issues going on anything that has to do with hormonal hot flashes, migraines, headaches. Like I was talking about you know, carpal tunnel? I actually thought almost on a weekly probably on a weekly basis, actually, if I really look at it, knee pain, things like that. So, pain, allergies. Come on in.
Dr. David
I do have one question. I think this is super helpful for the listeners. Do you have an example, you not to share any names, of course, have a client that had a really cool success story like with fertility specifically? They came in and maybe waited too long to see you, and then you know, they were having a fertility problem, and then ended up having a great outcome.
Adrianne OrtegaĀ
For sure. Yeah, for sure. I have a patient right that I can think of to him right now. And I'll try to set both really cool. Yeah, really good stories. One of them. In particular, I believe she's 38 years old. She has two children and got remarried. Comes in. Now they had already gone to reproductive endocrinologist really doesn't want to do IVF she just like I really don't want to do it. It's so expensive. It's so much work. It is a lot of work. I tell women doing IVF is like having a part time job takes longer than the intense. And I was like, oh, there's male factor here. We can improve these numbers. Let's improved the quality of your egg. Let's improve the quality of the sperm. And let's see what we can do here. Like it already seen the reproductive endocrinologist. The doctor told her you needed to go just straight to IVF. Like that's what he told her. Okay. On the second month, she got pregnant.
Dr. David
Oh my gosh. Second month working with you.
Adrianne OrtegaĀ
Second month. She took the herbs, she took the supplements. She tweaked her diet just a tad. That was huge. He made some changes. He took his herbs. That was it.
Dr. David
So, the so just let me make sure I got the story straight. So, your patient had seen another doctor who was recommending they had tried some stuff recommending going to IVF which is invitro fertilization.
Adrianne OrtegaĀ
He himself that does it, recommended that she do invitro right away.
Dr. David
And just a side note, what's IUI I I'm not sure.
Adrianne OrtegaĀ
Intrauterine Insemination.Ā So, IVF invitro, puts the egg and the sperm together and makes an embryo right. IUI it's just timing it. Does that make sense?
Dr. David
Yeah, it's all happening inside the body.
Adrianne OrtegaĀ
Yes, exactly. And then IVF happens outside the body, which is considerably much more than so let's add another $20,000 to it.
Dr. David
Wow. Yeah, that's a lot of a lot of dough for sure. Plus, all the work involved. Okay, so then this lady, your patient, was recommended to begin IVF treatment which is the more expensive, more time-consuming version, she came to you did treatments for to within two months she was pregnant. Naturally.
Adrianne OrtegaĀ
Yeah. And I told her you got to give it three months.
Dr. David
That's awesome. That's crazy. Yeah. And is that a common outcome for you like is that very typical?
Adrianne OrtegaĀ
The average actually is three to seven months.
Dr. David
Okay, so that was a faster one.
Adrianne OrtegaĀ
It was.
Dr. David
But three to seven months is about either was comfortable. You're waiting for a year.
Adrianne OrtegaĀ
Right? Right. So that's why I always say coming sooner than later. Don't wait for the year. Just coming after six months. If it hasn't happened. Come in, let's just get everything going faster in that way. Everyone's happy and can go on and have their family move on. So, the other patient I want her to actually touch on is a PCOS patient.
Dr. David
Polycystic Ovarian Syndrome.
Adrianne OrtegaĀ
Correct. So, there's like a hormonal dysregulation going on. I've been trying to conceive for about a year, and nothing had really happened. Also, I noticed that there is a male factor. So, I made some suggestions for him. He never needed to really come it wasn't that severe. He needed to come in and get acupuncture. But send him with some herbs. boxers, not briefs, which is a huge thing, right. And then for her, she just started coming in. She was in my office. You know, she came in here once a week for three months. It took a little bit longer. She also went to a doctor, and the doctor was like. āNo, we need to do IUI for a couple of cycles. And then we'll reevaluate, because this is not this isn't working.ā And so, she was actually going to do IOI. And she actually got pregnant. I think it was on the fifth month. She got pregnant on the very fifth month, and she's 38 Weeks Pregnant this this week.
Dr. David
Oh my gosh. So, they're expecting pretty much next month. Wow.
Adrianne OrtegaĀ
Yeah, so she worked really, really hard. I was super, super proud of her.
Dr. David
That's awesome. That's incredible to hear about. And I'm just the, because, you know, we have three kids, I have three kids, my wife and I, and we're very fortunate to both be very fertile. Don't have any problems, thank God. But, you know, we hear about it all the time. We hear about people having miscarriages and struggling to get pregnant and having complicated pregnancies. And, and we hear about the pregnancy, typically, because that's when people announced like, āIām pregnant!ā, but we know we don't hear about all the stuff that happens before, which is when you're dealing with the fertility side of things, leading up to getting pregnant.
Adrianne OrtegaĀ
Which is really stressful. It doesn't really matter what the couples struggling with. Whether it's recurrent pregnancy loss or it's male factor or it's PCOS or its endometriosis or whatever it is. It's really hard. And what happens a lot with these families, they feel very isolated. And there's a lot of shame and stress associated with it as well. It's not something that always talked about, I think more and more people are being more honest and truthful about what is going on what they have been suffering with. But it's still not at the level I think that people are really aware of.
Dr. David
Yeah. Oh, yeah. People don't talk about this on a regular basis for sure.
Adrianne OrtegaĀ
And, you know, part of it is that people are waiting longer to conceive, right? You want they want to go to grad school, or they want to go to law school or, you know, all those medical school like, that takes a long time. So, there are other factors that are playing into this, but I do know that acupuncture helps with the stress.
Dr. David
Yeah. Oh, yeah, I can. I can vouch for that. For sure. My wife has seen Adrianne, my hope my wife doesn't listen to this. She gets night terrors so she wakes up screaming in the middle of the night and you know it was it was a serious problem to the point where she was having to you know get a sleep study done and she was she broke her hands what happened she got a middle the night fell out of the bed broke her third metacarpal which is a bone like right in the middle of the hand one that you never really ever break it's not at all common.
Had to miss work for two months and the doctors after the sleep study said well, we could put you on medication that's going to be the best thing. Or you could try meditation and my wife was like I don't want medication. I can do meditation, I can pray, I can do all that stuff. But you know I need something else to it's not it's not cutting it one time she fell in nicked the corner eyebrow on the nightstand and you know, an inch down or less than it would have been her eye. Who knows she have two eyes at this point? And she's doing it subconsciously you know she's asleep.
So, I didn't even know Adrianne could work with people in this situation. But you know, I can see how it's a stress related issue and my wife has had a much better outcome since then she still gets little flare ups here and there. She's very conscious of managing her stress, of course, but Gosh, if it gets out of hand, we're coming right back into sleep.
It's pecking on the medications because that's a little bit ball game. And you know, if it's, I'm not personally and I think you're probably the same stance, I'm not completely against it in the right situation, the right circumstances, but there are other alternatives many, many times more often than not.
Adrianne OrtegaĀ
I agree.
Dr. David
So, do you have anything else you want to share with El Pasoans before we start wrapping up?
Adrianne OrtegaĀ
Yes, if you are someone who you know, is going to be embarking on IUI or IVF, you want to send them my way? Or do acupuncture don't have to do with me, if they're in Phoenix and tell them that kind of good acupuncturist because it'll increase your chances of concession two-fold.
Which is by 50%. And if you know anyone that is either a first-time mom, they're pregnant. You know, if they start coming in at 36 weeks, once a week, it decreases labor by three to six hours. I think that's pretty huge. They don't call it labor for nothing. So, yeah, I could help in any way. That would be great, because I've had some amazing success stories with first time moms that came in.
Dr. David
That's nuts, decreasing labor by three to six hoursā¦ Ā I've seen my wife go through labor three times. And if we could keep it to like five minutes, that'd be awesome. So that's an awesome statistic. Great! Well in closing, so if anyone wants to come and learn more about you or your clinic, or maybe even make an appointment, what's the best way to get in touch Adrianne?
Adrianne OrtegaĀ
For sure. You can call us here at 915-201-9303, you can also check out our website, maybe learn a little bit more. I mean, go to almaacupuncture-ep.com, and you can just hit us up whenever you're interested in ready to make an appointment.
Dr. David
Awesome. Thank you so much. I really appreciate you coming onto the show and giving us your expertise. So, we can spread this all over El Paso. If I just thank you so much. I'm really grateful for you.
Adrianne OrtegaĀ
Thank you. It was fun.
Dr. David
We'll see you guys later. Bye.
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A big welcome from El Paso Manual Physical Therapy
/in Podcast/by dmiddaughDr. David
This is Dr. David physical therapist from El Paso Manual Physical Therapy. Welcome to the show here. This is our first official episode for the podcast. And in order to bring this in right to get a good start. I wanted to bring on my lovely assistant Amber. She works in our office and she is the person that you'll talk to, if you ever give us a call.
This is not going to always be me on the podcast being interviewed. In fact, it will rarely be the case. This is just the first episode. In future episodes, you'll be hearing from physicians, acupuncturist or other medical professionals around town. The point of this podcast is to highlight other medical experts in El Paso. I just wanted to introduce you guys to El Paso Manual Physical Therapy therapy first and then we'll definitely be getting you the tour of a bunch of experts from El Paso. So, without further ado, Amber, welcome onto the show. It's nice to have you here.
AmberĀ
Thank you, Dr. David. Hi. Thank you for having me.
Dr. DavidĀ
So, Amber has been working with me for coming up on a year now?
Amber
Yes, yes, about a year now.
Dr. DavidĀ
It's been a wild ride with her, things have gotten so much more happy, cheerful, light-hearted in the office
Amber
Fun. We're having a great time.
Dr. DavidĀ
It's been awesome. It's been tons of fun, and I've got to know Amber and her two boys and her husband. We have kids roughly the same age, a little bit older than mine, but they love hanging out whenever they get a chance to be with each other.
Amber
They do. They're awesome. Good kids.
Dr. DavidĀ
Yeah. So, Amber, you are going to interview me? Go ahead and ask away, wherever you want to start.
Amber
All right, Doc, let's start here. Tell me your name, where you are from, and where did you go to school?
Dr. DavidĀ
Let's do it. So, my full name is Dr. David Middaugh, I'm a physical therapist. I have a doctorate in physical therapy. I even did some advanced doctor post doctorate training and that's called the fellowship. And what FA MPT stands for is the Fellow of the American Academy of Orthopedic Manual Physical Therapists. It's a big mouthful. The gist of it is, well let me start in high school, I went to Jefferson High School here in El Paso. And I didn't go to the silver magnet health school I was not in the medical field at that point. So, I was not interested at all and ended up going to UT Austin in for undergrad.
I got my bachelor's in kinesiology there. And it was during that time that I learned about physical therapy and that's when I decided to do it. Then I went straight into physical therapy school. It was a doctorate program at Texas State University, just down the road from Austin and San Marcos. And immediately after that, I started working in Austin as a PT and then went over into the manual therapy program, also held there in in Austin. Ā All that mouthful, the FA MPT stuff is just on a specialist in handling, and doing hands on work, and helping people prevent surgeries and get off of medications and get back to being active and healthy.
Amber
So, tell us a little bit about your lovely company. That's awesome here. Yes.
Dr. DavidĀ
We have been going on for almost five years now. And currently we are located at 2601 Yandell, in suite 232 in central El Paso. We are in the office here and we are looking out the window we can see the Franklin Mountains. You see the antennas on top. It's actually kind of a windy,
Amber
cold view here. It's really nice. Yeah, we got a good spot.
Dr. DavidĀ
Oh, yeah. And we currently have a couple treatment rooms and nice little comfy home setting type office. I love it. The last patient that was here this morning was just commenting about how it feels like a home more than a medical office. Right? We have a
Amber
Good environment. I like being here.
Dr. DavidĀ
Oh yeah, kick off their shoes here, walk around in socks or barefoot and they just feel
Amber
it is it's like family here. It is really. It's a great place to be. So now tell us, why did you start your own practice?
Dr. DavidĀ
Yeah, great question. I started because I just knew that I wanted to be able to treat patients one on one with the skills that I have in orthopedic manual therapy. So, the hands-on skills, it just requires one on one time, and then the education piece of happens and showing them the right proper exercises, to do everything that's right and necessary to avoid surgery and avoid living life on painkillers.
I just needed to be one on one, and all the other practices that I've worked at the business models that I've been in, they have overlapping appointments where they see at least two sometimes three, four more patients all at the same time, and everybody is kind of doing cookie cutter treatments for problems like back problems, or whatever it is. It just wasn't a good fit for my skill set, and I just knew I could help people better if I had them one on one. So that's what we do here is it's all one on one appointments.
Amber
Right and we do have those one on one appointments. Now tell me something unique about your practice.
Dr. DavidĀ
So, besides the one on one appointments, a lot of the visits, probably 95% of every visit is pretty heavy with the hands-on skills and techniques that we implement with our patients. Basically, patients come, or they are here for the stuff that they can't do on their own. We teach them what they need to be doing on their own. But of course, you know, getting a certain joint loosened up or muscle unstiffened or just getting them to move the right way.
Like a lot of people move funny in their knees and don't even know it and we have to just put our hands on them and guide them through the motion. That's something that we truly take the time and get our hands-on people, and even with initial visits here, the first-time people come in, we do what's called a discovery visit. We get our hands on them and we check out their knee problem, their hip, back or shoulder problem, whatever it is that we're seeing. It's a big drastic change from other medical offices that may just talk with them and run a diagnostic test and never put a hand on them and try to come up with a diagnosis without having laid hands on them. So, we touch everybody so that we can do the best job possible.
Amber
Nice. Nice. Can you tell us a little bit about knee problems?
Dr. David
Yeah, knee pain. That's a doozy for sure. Well, we see people with knee pain all the time here. It is definitely one of the most common problems where people get surgery for, and it can be completely avoided, I'd say and 9 out of 10 times.
Amber
Which we definitely do see around here a lot coming in. They were going to have surgery and then they walk out of here in a nice little timeframe. Yeah, I've seen it quite a few times.
Dr. David
Just a few days ago one of our patients Suzy was in here. She came in for a meniscus problem and she had her first visit. She had an MRI showing a torn meniscus. She was doing some stuff with her church and took a funny step, her knee popped and swelled. She was on crutches for a while, freaking out about possibly needing a surgery. She's in her late 50s, and she loves to be able to move fast, clean her house, take care of everything she needs to at home and with family and friends. And she loves going out to visit people. She just was all of a sudden slowed down tremendously you know, fast forward to today.
Amber
Hold on. Let me stop you right there. And let me go back to yesterday. She was in here doing weighted squats.
Dr. David
Yes. Okay. It's been two months. And she had a 45-pound bar on her shoulders and was doing squats.
Amber
Unbelievable. When she came in. She was on crutches.
Dr. David
So, it's pretty awesome. It's really cool. And she's got to do that because it's just the way to prevent the problem from happening again. So not everybody will do squats, but itās just a great testament to how fast people can improve and never have to have a surgery.
Amber
Right? So, what got you interested in focusing on knee pain, overall?
Dr. David
I have had knee problems over the years when I was in high school playing football. I also ran track, I did cross country, and I was always been active. During my years as a personal trainer I did competitive running as well. I've had patellar tendonitis. I've had this really rare injury called the poster lateral corner injury on the right knee. I thought I was going to have to have surgery a couple years back. And as soon as I heard those two statistics about having to have surgery for that. I said, āHell Noā, what can I do to make sure this doesn't happen?
So, I've always been interested in the knee and I've been able to, thankfully help a lot of people with their knee problems as well. It's just something I enjoy dealing with and I always have to look at contributions from the foot, the hip and even the back. And it's just an awesome puzzle for me to solve. I love it, it's just entertaining for me. On another level it's just I'm passionate because it's so rewarding when I get people like Suzy they come in and it's like you went from crutches to weightlifting in a matter of weeks! That's incredible!
Amber
Right! So okay then, what makes you an expert?
Dr. David
Well, I've done the training beyond the doctorate in physical therapy. Well first off, not every PT is required to have a doctorate degree, there are plenty out there practicing with a master's and, and even with a bachelor and you know, many of them have gone through extra training and are definitely pretty darn good. I just thing that the doctor levels, you know, itās just the pinnacle. And then I've done the post doctorate work.
So, I'm a specialist in being able to, by hand assess and treat the knee and other parts of the body, but also with the exercises of the movement. So, we use the focused exercises, those are critical for making sure that the problem doesn't return. I've seen tons of knee injuries and some really bad ones that have gotten way better. Now of course we see the post-operative knees, those are kind of easy, because they have already had a surgery and we know what was done with the surgery. A surgery is pretty much a controlled injury of slicing you open and then nipping certain things and sewing it up.
It's nice afterwards because the rehab process is straightforward because we know it was cut on. But if there has never been a surgery, then it's kind of a puzzle to figure out, and it's not always something that the surgeon might be an expert in, or even a physician. Somebody like me a manual physical therapist is the best person to see for an injury that's never been addressed surgically, and something that you're looking to treat without surgery. If it's a mechanical problem, meaning there's a meniscus problem of cartilage, muscle, bone, joint, ligament, or tendon, all that stuff has to deal with the mechanics nerves as well as to the mechanics of the of the joint. That's right up my alley. That's what I live and breathe every single day my life.
Amber
Right. Okay then. So why should people here in El Paso, come see you for knee pain?
Dr. David
Yeah, well, to my knowledge, we are the only clinic in town that specializes in avoiding surgery and getting off of painkillers and being active. Most of the clinics they may not outright advertise or talk about themselves as being specialists in any certain way. But they tend to see a lot of post-operative cases. In other words, the ACL repairs, the total knee replacements, the discectomy is where they cut off a chunk of the meniscus. And that's all they see all day long. And they are really good at doing that. They are fantastic at doing that. In fact, if you have a surgery, you are probably going to do really well, just about any PT clinic here in town.
But if you are looking to avoid one of those surgeries, then that's a different ballgame. If you are talking to a therapist that has that, you know, day in and day out, sees post-operative cases, and you have never had a surgery. They are just not going to be a specialist. It's kind of like if you drive a Mercedes, and you take it to the mom and pop dealership, and you see a bunch of older, lowe- end cars parked in the shop. You might want somebody with a little more skill to deal with your Mercedes so you can get it back up and running.
Amber
Most definitely, absolutely. And I can actually say that I do get to see a lot being in here being in the clinic with you. I do see the before and after, of when the patients and clients come in. And it's really neat to see that they come in here with sometimes little or no hope. And then, in a short time they are walking out of here without a surgery. It's really awesome to see it from my aspect, from my point of view, and to actually be able to talk to everybody.
I fall in love with them, when I hear their story. And it's just amazing that they came in here, just so beat down and ready to have surgery and give up on everything. And some people like Martha, she told me she was at the end like there's nothing anyone could do for her. And she is at home and her daughter called me āPlease tell my mom to stop sweeping the driveway. She's doing too much.ā You know, it's just amazing that I get to see these people firsthand. And I think it's really awesome. So, I want to know, when should they reach out to you?
Dr. David
So, you know if you have knee pain that just started today, or even in the past couple days, that's not a situation where, you would need to call us right away. Now if you have a chronic problem, like it's been ongoing, it comes and goes for months or even years, that's when somebody like me could definitely make a big change. Our clinic is set to help people like that. So, if, let's say, you sprained your knee, you take a funny step and it swells up, and you can't move it very well and you're limping. Give it some time. Try the natural stuff. You might even try a little pain medication over the counter type stuff, as long as you know your doctor is okay with it and you don't have any issues with that.
Simple pain relief treatment might get you through that if you feel like you're 100% after a week, no big deal. That's not a point to call somebody like us. But if the swelling has been going on for weeks, months, years. If you feel like sometimes you need a cane or a crutch to walk on. That's definitely a point to call us.
The most common reasons people call us for knee problems though is that they can walk, they can do everything. But when they do a little more, for example, if they go to the gym and start jogging on the treadmill, or get on the elliptical, or if they have to climb, go up or down a lot of steps so they go for a hike because it's nice. The mountains are really nice hiking areas, and then they have knee pain and it's frustrating when every time they try to be active, or cleaning the house, getting down and kneeling and squatting, the floors and all that a lot of people have trouble with that. But everyday things it's no big deal.
Another one is people that get knee pain after sitting for too long, they might be fine most of the time. But if they have been sitting at work for an hour or more or going to a movie and their knee just aches and the first few steps after they have been sitting for a while. Or if they have been asleep and they get up. Those first few steps can be very painful in the knee. That's a situation where there is some underlying problem that needs some sort of specialist help.
You want to give us a call and discuss what kind of options are available to you for fixing this knee problem, because you should not be living with knee pain no matter how old you are. It's not normal. Yeah, a lot of people say that though. I'm old. I'm getting old. So, she's probably getting old. But no, you can be 78 years old plus and feel fine.
Amber
Absolutely. Yes. So, what is something helpful that you often share with your patients that they usually don't know?
Dr. David
Arthritis in the knees is a huge problem, and a lot of people are told, especially those in their 50s and 60s, if they have a knee problem, the typical routine is like go to the doctor. The doctor says, well, let's get an X-ray. Let's look at the knee. Then they go back for the follow up results, or maybe if they do it in the office, the doctor shows them on the X-ray, hey, here's your knee, and you see this bottom edge where the joint is? That's all arthritic, you have arthritis in your knee. And then, if the doctor isn't a specialist at rehabilitating, they will just tell you something like, it's because of your age and you are only going to get older and your arthritis is going to progress. That's why your knee hurts and they might just leave you hanging and say that that's the best they can do with the knowledge they have.
The reality is, and what most people don't know, is that you can have painless arthritis. In other words, say your same situation. You go to the doctor, get the x-ray, they show you the arthritis, your knees hurting, that's why you went to the doctor. If you do treatment, kind of like we might prescribe. And if you were to go back and get an X ray, your knee would probably look the same. With the line of arthritis inside the joints. As long as your arthritis isn't super severe, your chances are you are going to do really well despite the arthritis.
Amber
Okay, now do you have anything else you'd like to share with our wonderful listeners.
Dr. David
Yes, so we are also really good at treating back problems. We see a lot of people for problems in the back, like muscle spasms, pinched nerves, and sciatica problems. We also see people for neck problems and nerve problems associated with the neck like they call it ridiculous apathy, where people get numbness and tingling in the arms, and shoulder problems. A lot of people complain of knots in the neck and shoulder area. And it can get pretty bad to the point where people can't focus and concentrate on just the work, or their family and relationships. The worst is when people say they go home grumpy,
Amber
Or they want to go to the emergency room. Oh, yeah, that one we had with my lovely friend Jordan. She said she was fine, but she wasnāt. I told her to come here. She is one of my favorites. She came over. She was actually stuck bent over, and she couldn't even stand up.
We talked to her right before going into the emergency room.
Dr. David
Right. And and of course she didn't know what to do about her problem. She is probably going to get muscle relaxers and pain relievers. They might even do an injection and then tell you to go home and rest. And that's like the worst thing you could do. I mean, if it calmed her pain down, she could actually, sleep, but it didn't go away. It just masks the symptoms. But when she started coming here, she started progressing week by week. 10, 20, 30% and the girls lifting weights now.
Amber
Yes, she is and she's doing wonderful. She just called me and thanking us again. So, if someone in El Paso wants to learn more about our clinic, and possibly even make an appointment, what's the best way to get in touch with us?
Dr. David
Yeah, super easy. So, you can look on our website. The website is www.EPManualPhysicalTherapy.com. Ā Or you can call us at 915-503-1314. And if you call that number, you'll get to talk to Amber
Amber
Yes, you are going to talk to me!
Dr. David
And then you'll have a fun time talking to Amber. What I love about what Amber does is, most people that call our clinic, are not the happiest. They are dealing with some problems. They are on the verge of going to the ER, that kind of situation. And Amber makes you feel so much better. She makes you feel glad that you call the right place. And I frequently get people come in once to see me because we'll talk to Amber first, and when meet with our patients in the treatment room, they say, āI love talking to Amber!ā. There are many times where I'm done with one patient and the patient before, is still there talking with.
It's really nice when you are having a rough spot, because of your knee, or your back or whatever it is. And you have a ray of sunshine to brighten your day.
Amber
Thank you. Thank you so much. Yes, I do love having everyone that we have in here, they turn into really good friends or even like our family. So yeah, it's been really fun.
Dr. David
Yeah, well thanks so much Amber I really appreciate you for coming on. I hope to do more maybe we'll hear from you in the future as well, and to those of you that end up meeting us one day you'll definitely love meeting Amber
Have a wonderful day everybody. Bye.
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