SPEAKERS
Brett Scott
Brett Scott 00:01
All right, everybody, Dr Sarah Vosa here so I’ve known Sarah for a long time. And we’ve talked a couple times about some different things and you had me on one of your Facebook group talks but Sarah is someone who has a very non traditional approach from regular PT, traditional medicine anything like that. So sir, I want to start with is your PT practice anything like you thought it would be when you may be first finished school?
00:33
It is nothing like I thought it was going to be when I first finished school. I wanted to do sports medicine all the way you know, sports orthopedics, so I am so far from that now. I never pictured myself ending up here.
Brett Scott 00:50
Yeah, and so for those of you that don’t know, Sarah, She’s the owner of body and mind PT in Are you in Windham, New Hampshire went up. Okay. So Sarah has a very different look at the body of she does some very different approaches that I haven’t seen much of in the field that include. What are we looking at here? The visceral manipulation. So working on and looking at and assessing the organs of your body, cranial sacral therapy Somato, emotional release therapy, neuro neuro manipulation, food sensitivity testing and leaky gut testing. And I think it would work with a lot of autoimmune type disorders as well.
01:35
I do. Yep. So I also do diagnostic ultrasound, so I can take a peek what’s going on inside as well.
Brett Scott 01:44
Okay, cool. So how did you end up getting into these different modalities and interventions as a physical therapist, because I don’t think anyone comes out thinking they’re going to find a physical therapist that can treat their organs and what’s going on there.
01:59
Yeah, so that, you know, I’ve heard research called me search before and my own story. And my own journey is what kind of led me into this. I wanted to become a physical therapist initially from a car accident that I was in and it shattered my femur, so my thigh bone right at the knee joint. And so that started me in treatment and physical therapy and high school, went to college, just kept going with it. And then when I was in my late 20s, and I was pregnant with my second child, I got really sick. I saw eight different specialists at MGH, people were having a very hard time, the doctors having very hard time figuring out what was going on with me. And I ended up seeing a doctor vasculopathy and wooburn that did cranial sacral therapy, and she coupled it with some emotion modalities, and also a naturopath who worked on some food issues with me, as well as a whole bunch of other stuff. But when I saw the Osteopath, it was very, very helpful. And I thought, well, this is something I can actually get trained in, and it’s helping me far more than anything the providers at MGH were helping with. So that’s, that’s kind of where I got started, I went and took the training for cranial sacral. And that was my, my journey down that path.
Brett Scott 03:18
And so for you now, so as you know, myself, as a provider, typically what we’re looking at, might be a little more than traditional PT, where we try to really dive deep into who a person truly is, what stressors are on their body, what the demands of maybe their physical activities are, and how well certain things are moving, and might not be moving, and possibly why. And I think that’s typical of most, you know, physical therapists that are working in the outpatient sports type setting, but how are you looking at the body? So if someone comes in to you, they’ve had chronic pain, maybe some autoimmune disorders? What questions are you asking this person off the bat? And what types of things are you looking for?
04:10
So we do a full lifestyle. Kind of assessment, we asked about diet hydration, and I think most PTS probably do some of this sleep. Definitely movement, which LPD should be doing if they have any mindfulness practices, but we kind of go through all of that, see where there’s maybe some areas of weakness. Other things that I look for are, what their position in their family of origin is, are they an oldest child and only child the youngest child wherever they fall among their siblings? Because that will tell you a lot about possibly their how they were treated growing up. You know, oldest child tends to be identified more than like the youngest child, something like that. And then we also look at And what’s happening kind of, in maybe the main part of the body here. So when we talk about visceral manipulation, there’s two main components to it. One is how the organs are sliding and gliding over each other. So if you fall, both bend forward, your liver has to glide underneath your diaphragm. So you want to make sure that those tissues are mobile. And when we do this role, we’re not necessarily working on like the liver itself, we’re working on the right triangular ligament, the left triangular ligament, the falciform ligament, and so we’re working on all the tissues that suspend and support the organs around them. So that’s so it’s still ligamentous it’s just ligaments or organs, not ligament fell into bone.
Brett Scott 05:45
Okay, and so when do you see things go wrong with these organs? Like what what is happening to people typically, that makes them become maybe dysfunctional, and something that needs some some tender loving care or
06:00
care? Yeah. So there’s, there’s a whole bunch of things that could happen. One, it could it could be positional, like typical physical therapy, looking at repetitive movements, or lack thereof movement that we don’t move enough, we’re not moving in new and unique ways on a regular basis, you know, I’m moving in a straight plane, so you’re not getting movement in certain ligaments. It could be food related, if you are constantly eating food that you have intolerances to, or allergies to. And you’re getting inflammation in your gut all the time. So your small intestine is inflamed, you could have some irritation in the stomach lining. So though the organs are a little bit swollen, and so they’re not going to be able to move the way they should in their cavities. It could be because of that. And then the biggest reason that I see is it, it’s an emotional component. So the big word that I use a lot is interoception. Have you heard that before that word
Brett Scott 07:04
I’ve heard it I don’t really know much about, I’d love for you to talk more about it. So
07:08
interoception is one of our senses, not the five ones that we learned about as a little kid. The other ones we learned about in PT school are proprioception and vestibular. And then the third, one of those is interior reception and interior reception is our ability to sense the internal sensations of our body. So we lose that over time, as you know, we get a stomach ache, but we have to go to work. And we kind of just ignore and push through it. So we train our mind to not pay attention to the sensations in our body. And the work I do is really working on connecting the mind to those sensations, again, our emotions form from the sensations that we experience in our body. So those send signals up the vagus nerve to the brain that helps our emotions form. And then signals are sent back down the vagus nerve based on our threat response, or lack thereof a threat response. So a lot of times I work the restrictions in the in the body come from either ignoring the emotions, suppressing them, pretending like they don’t exist, whatever whatever coping mechanism was affected in the moment usually becomes detrimental long term if it’s not addressed.
Brett Scott 08:23
Okay, so question here,
08:25
if it doesn’t make sense to just ask questions, because sometimes it makes sense up here in my head, and I have trouble getting it out.
Brett Scott 08:32
though. It makes sense to me. But so do you think a lot of these gut health type disorders, leaky gut, whatever, could truly have a start as something that happens in the brain as a coping mechanism for, you know, life stressors and emotions and traumas and whatnot?
08:54
I do. I think there’s a component of that. I don’t think that’s the whole thing. I don’t ever want to put it on that. A lot of people who have chronic health issues have been told oh, it’s just because of your mental health and kind of dismissed because of that. So I don’t ever want to dismiss somebody because of that, because there usually is a physical component as well. And then when you come to the gut issues, you know, you can look at our food supply in America and how we treat our food. And there’s an issue there too. So I don’t think it’s just I think it’s multifactorial, I don’t think it’s just one thing, but I do think that there is a big component of mental health emotional regulation that that plays into that. And I A lot of times relates things. Like sometimes if a person’s had trauma and they’re hyper, I can’t say this word hyper vigilant because of that vigilance. vigilant, vigilant. Thank you. Because of that their immune system over time if that’s a long term coping mechanism they use their immune system will become that way as well and then they move into autoimmune. If people have a lot of trouble Go with boundaries in their personal life forming and maintaining them. Sometimes you have boundary issues in your gut, you have leaky gut. So it kind of correlates similarly in that way.
Brett Scott 10:12
Very interesting. And for those that don’t know about leaky gut, Sarah, how would you describe leaky gut syndrome.
10:19
So you have these, all your cells meet together inside your small intestines, and you have junctions where those cells meet together, and they’re supposed to be tight junctions. And over time, as things damage the inside lining of that the cells kind of become, those junctions become looser, and so bigger molecules are able to get through and the body starts to recognize those as things that they need to attack. But those molecules actually rapid are very similar in size and makeup of some of our own tissues. And so then the body gets confused. And then it ends up usually having like an autoimmune issue where you’re attacking your body, not just the large molecules that are getting through.
Brett Scott 11:05
So leaky gut is a very interesting topic all in and of itself, because I’ve seen a lot on it for years, like I’ve, I have had plenty of autoimmune issues myself. I’ve had gut issues, I had a parasitic infection for a while that I was dealing with and still kind of healing from. But there’s plenty of people out there that say leaky gut isn’t real. And it’s, you know, there’s no science behind it, and this and that, but it definitely seems more and more like we’re coming to terms with the fact that like, this is something that’s happening. I think, in the past few years, we’re starting to see that like, oh, all the gluten that we process in this country is actually negatively affecting our gut. And we can’t process it the way we could like, I’ve heard of plenty people that have like celiac disease, going to Italy and eating all the gluten and being completely fine. So what are your thoughts on on leaky gut as itself and where it kind of lands in the medical literature and how we treated in this country? And what patients should keep in mind if they go to see a provider that tells them? No, there’s no such thing as leaky gut.
12:15
I think more and more providers, even in standard western medicine are becoming open to the idea of leaky gut, I actually haven’t had any providers tell me that they they don’t believe in that even my providers at MGH, you know, the technical term would be you have increased gut permeability. And there are measures for it, blood measures, so you can measure the level of Zonulin through a blood test, which is a marker that increases in the blood when those junctions become looser. In the gut, there’s a clue. I’m gonna say the other one lesion. I can’t remember the other term, but there’s two different markers that they measure on blood test to determine if there is a risk of leaky gut. And then you can see, I believe that they can do biopsies on endoscopy to test for that damage as well. So I don’t think that it’s, you know, I think that some people might think it’s a trend. And it’s like the popular thing right now. And that it’s not as as big of a deal as it actually is. But I would say it’s actually a pretty big deal. And if you look at like the gluten in the US versus the gluten in the in Europe, I’m hopefully going to be able to have some gluten when I go to Europe this spring, we’ll see I’ll try it because I do have celiac. So we’ll see how that goes. But, you know, the gluten in our country was modified, I believe it was genetically modified, applied in the 70s, I think. And that’s where that change has happened, I think and also the amount of Roundup or glyphosate that we use on it. dispensary, so that that started to increase in the 80s in the early 80s, you know, it used to just be sprayed on the field and then in the early 80s, they used it as a drying agent during the harvesting. So like when it’s on the conveyor belt, they douse it in glyphosate to dry all like the greenery off so it’s easier to harvest and so that’s our generation, my generation as kids we got that and the generations before us didn’t get that as kids so I think that’s why you’re seeing more gut issues now than you were before. Yeah.
Brett Scott 14:19
There’s definitely issues with the way we processed food in this country and and what happens to us as a byproduct of that. So someone comes into what, what types of symptoms and conditions might these people have.
14:37
So my practice is primarily around chronic issues. I might get your chronic back pain, neck pain or headaches. But like a typical physical therapist, would I also see people who have si Bo small intestinal bacterial overgrowth, I get a lot I’ve seen patients for hiatal hernias, gastro esophageal reflux, gastric recess. So any of those digestive disorders that maybe aren’t responding to traditional medicine, I see a lot of a lot of people with those. I see a lot of post concussion syndrome. And I see a lot of people with PTSD.
15:18
And so stress disorder just for those who aren’t familiar with that.
Brett Scott 15:24
And so concussions is an interesting one, too, because this is something I talked with my functional medicine doctor about, about how, you know, there’s a lot of people know now about, like, the gut brain connection, and how they’re intertwined. But concussion is an interesting one, where my functional med doc was telling me that there are a lot of similarities between people that have different gut disorders, infections of the gut, what have you, and people that have concussions, they ended up having the same symptoms, yet, there’s a possibility that these issues started from a different event or different onset of one being a head injury, one being a gut injury. So what types of things are you seeing from the organs and in function, you know, down below the brand that are affecting our digestion, our you know, uptake of nutrients, everything else our stress? What’s happening there? And what do you do for these types of people that have these these disorders is like, I just had a patient that I was working with for a bit. And I actually sent on your information too, so I don’t know if she ever reached out. But she was like two years out from a concussion and having she had a lot of issues with cardiac where her heart rate was spiking in the middle of the night to like 130 beats a minute, it would sink and dive after exercise. So she had this, you know, dysregulation of her heart, but are those different things you can treat as well?
17:02
Yeah, so those are things that I commonly see in actually more on long COVID patients now, but they are often present similar to post concussion patients as well. So that’s just some autonomic regulation issues that the the signals are not getting sent appropriately to the nervous system. And with concussions, it’s the the brain and the gut are connected through the enteric nervous system. So the glial cells traveled down your vagus nerve to the gut, and then they talk with the lining of the gut and the enteric nervous system in your gut, and then they travel back up to the brain, again, through the vagus nerve. So the, it’s a constant cycle. So the, if the brain is dysfunctional, and those glial cells are not communicating correctly, then you’re gonna have a brain injury can cause gut dysfunction. And vice versa, like if you have chronic si do, and you might also be complaining of brain fog, similarly to a post concussion, it can be because of that pathway. So that’s why I think you have to address the food too, which is why I do food intolerance, testing, but then also addressing the, the physical components to so that’s I use a lot more cranial sacral and neural manipulation when I’m working with concussion patients, and for those people that are just popping out or maybe not familiar, both of those are gentle manual therapy techniques. And I use them with graded imagery. So we do a lot of visualization of the structures that that I’m working on.
Brett Scott 18:37
So how does that work? So you’re using neuro manipulation and cranial sacral. So what are you trying to do to this person that might have a concussion, and what is happening?
18:49
It depends on the patient. So this is the part that’s usually a leak for other providers. It is assessment, it’s a palpation assessment. And so you know, many years of training and lots of practice, not instantaneous, but working on areas of tension inside the body. So if I’m getting on someone’s brain, I might have my hands right over their frontal lobe. So touching the skin, and I am thinking and feeling at the layers as I go. So skin, adipose muscle, fascia bone, underneath the bone as you get your dura membrane. And as I do all of this, I am either using my 3d anatomy on my computer, or I’m taking out my model or getting out my mother’s anatomy book. And I’m teaching the patient about the anatomy as we go. And I usually have them look at the picture of the anatomy as I’m putting some sort of novel input, whether it’s my hands or a needle for dry needling into that tissue. And, and then we work on some visualization. So how does theirs look different from the picture in the book, if they were to close their eyes and they were to think about how they were going to draw theirs? Would it look the same? Would it look different? And if it looks different, how does it look to front is the dura mater or the fibers criss cross instead of parallel, is it thick and bumpy, or is it too thin and, and almost porous and it whichever way it is we do some graded imagery and visualization work to kind of bring that back to kind of more with a textbook picture would look like. So it’s a lot of, and that’s the interior reception piece, that’s the piece of connecting their their brain, their mind to the tissues in their body. So kind of re growing those connections. And when that happens, patients symptoms often get a lot a lot better. And they’ll have a lot less just because they’ve given attention and intention to those tissues that they, for whatever reason have not been able to connect with. Last week, I actually had someone who got a concussion ski racing with me last winter at Pat’s peak, and she has been having significant issues since. And we worked on her optic nerve. So she’s envisioned therapy as well I sent her to a neuro ophthalmologist. And she, she actually was even struggling with vision therapy and coming here. And so we worked on visualizing her optic nerves coming into the optic chiasm and then splitting back to the optic tract to the visual processing center in the occipital lobe. And while I’m working on the outside of her head and working on the tissues, she’s working on the visualization, and I’m guiding her through it. And afterwards she was like oh my god, my headaches gone. And I feel like my eyes are working together for the first time in months. So it’s it’s really about getting when I started doing this work, I was doing a lot of it passive just a manual part that I have found that once you get the patient’s brain involved in the action becomes more active for them with a graded imagery and visualizations and actually talking to the tissues. It sounds silly, but I’m like pretend this tissue is a person and let’s talk to it. And it works phenomenally. I have had such great results in the past. Probably nine months since I started doing that. And it’s it’s actually kind of mind blowing every day I go home. I’m like, no, no know what happened today. It’s just like little miracles all day long.
Brett Scott 22:12
Yeah, I will say it definitely sounds a little woowoo. Or probably sounds a little woowoo to a lot of people out there. But it’s, to me, it’s like well, I’ve had Reiki done with our friend Brogan and excuse me, the broken thing, I’d be open to it. But I think if you keep an open mind to anything, almost anything can work for you potentially. And when I’ve done Reiki, it’s a very different sensation, phenomena, whatever you want to call it. That’s just it definitely is doing something. And these are things that have been around for 1000s of years where with Reiki, like she doesn’t even put her hands on you, they’re just near you. But like I have felt like electric bolts like shooting from my feet up through my legs into my low back. And then like you turn over and the upper body was like I was sitting in this ice cold bath with like no clothes on. And it’s all that very interesting how that can work. And I think it’s definitely something that that sounds a little crazy. But I think people need to keep an open mind to it of like, what we’re doing and, and visualization is something too. We know and have pretty well studied. Now at this point that visualization is huge for sports performance. So why can’t we use it as something to yeah, get our, our mind and our nervous system and everything back on track with itself.
23:44
Right. So I don’t actually love comparing it to Reiki I also have enjoyed getting Reiki in the past. But Reiki is really you’re pulling from an energy source, you’re you’re a conduit, and you’re providing the energy to somebody else. I don’t. So I have patients who would be very against that for religious purposes. So I don’t pull any energy from any other source. What I’m working on is really it’s really neuroscience so really starting to create regulation in the nervous system and pockets where there has just been sustained dysregulation for long periods of time. So in physical therapy, we talk a lot about pain neuroscience has been like the buzz thing for the past, you know, decade or two. And I think pain neuroscience is great. I think that they ignore trauma neuroscience, so when they talk about pain neuroscience, and I think it’s important to recognize both and I know they do a lot of great imagery and pain neuroscience and I think that’s that’s wonderful. But you know, pain neuroscience would say, you know, I think the the famous story is you know, the guy was walking through the bush in Australia and the snake bit him and then the next time and he didn’t feel any that much pain and then the next time you walk through a stick had his leg and he felt a great deal of pain, and so that sometimes our brains can trick us and so he You would say, and this is kind of similar for what I do with PTSD people, he would say, Oh, you have to tell your brain that it was wrong. And that it was you know that there isn’t actually any danger. So he’s addressing the second situation. So he’s kind of pretending like the Snake Snake bite didn’t happen. And he’s saying, Oh, it’s not an issue. Now, let’s just pretend it didn’t happen, I would say, for trauma neuroscience, you have to go back and address the first instance, where you had the snake bite, and it became life threatening, and you have to address a dysregulation that occurred in the nervous system at that time. And then you will stop having these other issues, these other things that come up where that where your nervous system is already in dysregulation so overreact to something. So if you come down, back to the first instance, and treat that nervous system dysregulation that occurred from that, that experience, that you won’t have these false things later on, but then you have to basically kind of trick your brain into not reacting. So that’s that’s kind of where I go with it. So it’s really working on nervous system regulation.
Brett Scott 26:08
That’s interesting. I actually send that video from Florida more mostly the his TED talk there.
26:15
A lot of people a lot of physical therapists do and I think it’s, I think it’s great. But when you work with people who have a history of trauma, there’s there’s two methods, there’s top down and bottom up for recovery. And top down is using the mind to affect the body. So you know, if you have like these thoughts, like Oh, my God, this is going to be so bad, telling yourself, it’s not going to be so bad, what’s the worst thing that could happen and kind of tricking your mind, the bottom up works with the body and addresses the body to affect the mind. So we regulate the nervous system in the body. And as the body the nervous system in the body becomes more regulated than the mind calms, and you don’t have the intrusive thoughts, you don’t have the anxiety because the nervous system has moved into more regulation. And for people who have PTSD, often a combination of top down and bottom up combined is needed, that one by itself doesn’t work, but you need both. And so I think pain neuroscience has its place, I just think that we also need to address the dysregulation that’s happening in the body and go back to the root cause instead of kind of addressing in the peripheral stuff that happens afterwards.
Brett Scott 27:23
Okay, so in that situation, if you had someone that had a snake bite, and then every time they go in the woods, they think they’re getting bit by a snake that might be a life threatening injury again, how would How would you work on that? Like, what would your approach be?
27:37
Um, so usually, I don’t go to a specific big T trauma, we can but I often sometimes remembering the trauma itself and having to relive it can be more traumatizing, because it creates more nervous system dysregulation. So if it’s somebody say for instance, if it’s somebody who has some chronic pelvic pain, because I see that a lot, whether it’s I think his hips, Si, kind of chronic pelvic pain, I will get on a tissue, and we’ll start working that tissue, they’ll start talking to it, you know, we’ve done the guided imagery, they see it looks different. And if that tissue isn’t responding, if it’s not changing, I will say asked, asked this, whatever, I think yesterday, I was working on the Arachis, which is a ligament that holds the bladder up. And the patient it wasn’t changing. And I said to the patient asked, she said it looked like a bungee cord instead of like, instead of like a scrunchie instead of long and straight. And so I said ask it, how long it’s been there or what age you were when it developed. And she in like, it’s kind of more like, word association thing. It’s just whatever comes to your mind first. It’s because your mind is is ruling this year. And so she was like, I think it was when I was when I was 14 and I was like, okay, at 14, can you visualize your 14 year old self? And she said yes. And I said, can leave you now you that’s on the table, the mom that I’m treating? Can she interact with a 14 year old you and your vision? And what does she need, she needs a hug. She’s lapsing into my arms falling, she needs someone to just comfort her. And then that allows that peace, that nervous system that was dysregulated in that area of the tissue to move into regulation, and then it just relaxes and she’s like, Oh, the ligament looks straight now on my visualization. I’m like, great. So it’s really about when we don’t have the tools on board to process whatever we’re processing whatever happens to us in the moment or if we feel very alone, in that moment of dysregulation. Often we are never able to fully process it and then that kind of lives in our tissues so the body never lies by Alice I’m blanking on her last name or the body It keeps a score by vessel, plank and his last name too. But both of them talk a lot about that and their bumps about how our experiences that we aren’t able to process show up in our body, and then treating the body allows them to process and then allows the nervous system in that area to move into regulation. So then you’re not having symptoms anymore.
Brett Scott 30:24
Very, very interesting stuff. So do you think? And this probably isn’t an all or never. But do you think there’s people out there? I feel like there’s a lot of people now that are getting diagnosed with some autoimmune disorder that they don’t really know what it is yet, but something from an autoimmune perspective is going on. And maybe they’re being treated medically with medications, and pharmaceutical drugs. But do you think there’s, you know, issues going on out there with people that are living this life thinking they have something wrong through from a, you know, there’s a genetic coding issue, and really, it’s just trauma and issues that haven’t been dealt with it someone like you could help them solve?
31:11
I think that’s a combination also. So I think, you know, if there’s a genetic coding issue, it might be a genetic coding issue, and is that genetic coding issue because of epigenetic trauma and generational trauma, or is that genetic coding issue, because of something else, like the biggest one I worked with, and here is the MTHFR gene mutation, which changes the way our body processes, folic acid, we can’t convert B vitamins and folic acid into the body into the form, it’s needed for the body to process it. And so that leads to a lot of mental health stress. So a lot of anxiety is often seen with that. So getting people on the right supplements methylated B, vitamin supplement is really the biggest thing will help with that. And that’s you absolutely. Like you can’t just think your way out of that, you’re not going to change the fact that you have an MTHFR mutation, just by thinking about it, and dealing with trauma that’s always going to be there. So you know, addressing that appropriately, can help lower the anxiety, and then what that does to the nervous system, if you’re if you’re not getting if your brain needs these B vitamins to function, and it doesn’t have them in a form it needs, you’re going to have this constant nervous system dysfunction. So that’s going to take one piece away. And then you may have some other emotional stuff that you may have to deal with, or experiences that you may have to deal with to get to like a full state of calm, I honestly didn’t know that life could be as relaxed and easy as it is now because I’ve had my own struggles with PTSD after the car accident, I was in high school, and anxiety and depression as well. I had postpartum depression after both of my kids. So I’ve been down my own road with that. And if someone had you know, I the addressing the the genetic component is absolutely imperative. I don’t think that you can just discount that.
Brett Scott 33:13
Yeah. And so, because we just I see so many people that come in, they don’t have a diagnosis, like a medical diagnosis, but there’s definitely something systemically going on from maybe an inflammatory perspective, right, they have all this stress and anxiety. And I think a lot of traditional medicine has just, you know, bandaid to that with SSRI drugs and anxiety and depression meds. And there’s a whole host of other things people have too, like hormonal disorders, or issues and things that we’re just covering up with these band aids. And it’s just like, is there something else we could do to get to the root cause of this and it sounds like you were someone that kid could help people. Maybe we can’t get rid of the genetic component to it. But there’s a lot we can do to regulate our nervous system and how we, how our body is working to be more of an optimal manner.
34:10
Absolutely. I and I have to say I’m not against SSRIs and medication. I absolutely, I don’t think I’d be here if it weren’t for them. I took them after both of my kids and I had postpartum depression. And quite literally, I don’t think I’d be here if it weren’t for SSRIs. So I think they’re totally needed for me. I just didn’t want to be on them for my entire life. And that was my doctor’s plan. I think they were a great temporary solution. And then I needed to do things in my life with lifestyle changes and addressing my own mental health and gut brain connection and everything else to really be able to move through that and so I never tell people that I think they should get off their medication. If some if that is somebody’s goal. I’m happy to help them move towards that goal. I Um, but you know, we only see a small snapshot of a person’s life in our office, and we have no idea what they’re actually dealing with on the outside. So, you know, and how much stress that is. So I don’t ever usually encourage patients to get off them, I’ll help them if that’s their goal. But that’s kind of as far as I go with that.
Brett Scott 35:22
And so I’d like to talk to you a little bit about stress and trauma and how that affects our bodies and move them because that’s one thing, again, we see it all the time of people just come in, and they’re just this tight type A personality. They just, they, even when you tell them to relax in a nice, calm tone of voice, they still can’t get themselves to relax. There’s, there’s like, no sense of relaxation in them. And it’s, it’s like, okay, what, what is going on and they can’t breathe, it’s like, I have to remind them, even when they’re just laying there, you know, I could be doing like a hip mobilization, where it’s the pretty relaxing modality. And some of these people just like, can’t let go of anything. It’s like, you know, you start thinking about what what does this person dealt with it has put them in the state of just chronic stress and tension and people come in, it’s something we will discuss sometimes and ask some questions on but just so we have a better idea of you know, what the prognosis might be. But I think for people out there, they need to hear a little bit more about how our past experiences and traumas and everything else really affect our lifestyle, our movement, quality, everything else. So can you touch on that a little bit, Sarah?
36:44
Sure. So if if you want someone to be able to relax, when they have that tension all the time, that’s I’m gonna say it wrong. Again. It’s like I were to use this word all the time. I can’t say diligence, hyper vigilance, vigilance, vigilance. Thank you. Yeah, that’s that. So there’s the dyslexia. But that’s that the nervous system dysregulation that they’re constantly they’re constantly living in. And in order for them to really be able to relax, they need to create a safe environment internally. So that is a big focus of my practice is creating. So if someone comes in the first day, I never do any kind of trauma work with them, because they have to develop, they have to have trust with me, they have to know that I am a safe person to talk to about this. And so there is there’s a little bit of rapport that needs to be built to create that safety, and have that trust it. I haven’t practiced at it now. So it happens a little bit faster for me now than it used to, to create that safe environment for people to be able to be vulnerable, but they need to feel that they can be vulnerable, they need to feel safe and secure and stable enough that they can be vulnerable. And, and then once they’re able to be like a little bit vulnerable and kind of go to those uncomfortable places that maybe they’ve been avoiding. That’s when the relaxation will become more permanent and more sustained. I had someone the other day who I’ve been seeing for a few months now. And I only see patients once every three weeks or once a month. And she yesterday, we’ve talked about it many times, my shoulders are always up in my ears, I feel like my shoulders just supplement yours. And she finally was able when we were talking to the tissues yesterday, she was like, Oh, this happened when I was 14. And it turns out, she’s like, I’ve been like they’ve been like this since I was 14. And it turns out that her parents divorced at 14. So going back and providing her 14 year old self. So that’s kind of that’s kind of deemed inner child work in the mental health world. But providing her 14 year old self with the love emotional support security safety that it did. She didn’t get at that time. So that she didn’t she was like my shoulders just fell like I don’t not trying like I’m not like telling me like they’re just down now. And I’m like, yep, that’s because that part of the nervous system dysregulation that you’ve been carrying with you for years, has finally moved into a state of regulation. So now you’re not having to have this coping mechanism of garden all the time. So you know, when we feel stressed we guard and it’s a way in the same thing when we feel pain regard. It’s our body trying to protect us in some way. So if you offer it and let it know that the danger is gone, and you offer it safety and security, then it will naturally fall away. That tension that we’ve been holding. You know, as we move through life, we we experience things and we just kind of push through. But if you experience something and you are really tense when it happened and like you don’t ever go back to reprocess it, that tension is always gonna kind of be there a little bit. It doesn’t just go away. It’s not like it’s just disappeared. Now that nervous system destroyed you relation goes on until you go back and process it really for the first time,
Brett Scott 40:05
though, that’s kind of my next question. So with the movement side of things, if we’re looking at traditional orthopedics, it’s like, okay, you know, we have a stiff hip, and there’s plenty of things we can do to make that mobile. But if we’re not doing work on the back end between visits, and you know, you’re doing maybe some mobility work, maybe some stability work to keep it mobile, that stiffness comes right back, because you didn’t learn how to deal with the new movement you are given. So is it similar on this, like, emotional level of dysregulation of? So you see, these patients have been dealing with this for years, and they didn’t know what was going on? You get this person to get their shoulders to relax? How easy or hard is it for this person to jump back into the state of you know, shoulders elevated again, and being stressed like, what is it just gone until, you know, maybe some new event happens, it’s similar or
41:05
it can be, it can be gone until a new event happens, it might trigger it, and it might be similar. If it’s a coping mechanism that they use in every aspect of stress, like they use it all the time, every time they feel stressed, it’s going to come back. So that’s where, you know, still teaching the breathing techniques, doing the mindfulness mindfulness techniques is really helpful and beneficial with the work that I do. And then I love since I’ve added in the visualization and graded imagery, you know, I tell patients, you don’t have to get as specific as I am, you know, I might be like, in the medial wall of the right atrium, but like, look at a picture of a heart online on Google, there’s plenty of images, close your eyes, put your hand over your heart, visualize the space under your hand, what do you sense and it might not be as specific as it is when I’m working with them to get really specific on exactly what tissues we’re working on. But they might get like an image, Oh, it feels like there’s like a ball there. And it feels kind of like bumpy and black. And then we work on with the visualisation of that image that they’re able to get so that they can have that carryover at home and practice. And all of that grows, the interior reception, the ability to sense the signals and changes from internet from inside their body. And then as that interior reception grows, it just becomes easier to process. Because you’re not shutting it down all the time, you’re allowing it.
Brett Scott 42:36
So is this kind of what we’re talking about with the somatic emotional release therapy? Is that what this is entailing?
42:43
Yeah, so that’s a lot of this. So I said that emotion releases the it’s through the Upledger Institute, and that’s the one I’m trained in, it kind of falls under somatic processing. So I tend to use that umbrella term a little bit more, because I do some things outside of somatic motion release as well. But somatic processing is kind of processing those sensations inside our body, tuning into them growing that into your perception. So that we have better nervous system regulation, less stress, kind of in our daily lives. Yeah, so that falls into that. So sometimes people do have a huge emotional release while they’re working through this stuff. And sometimes it’s just like, Oh, she just needed a hug, I feel better. And there’s not some big emotional release with that. And that’s fine, too. It’s wherever the patient is mentally and emotionally and whatever they need.
Brett Scott 43:37
And I guess, what, what types of things would patients maybe experienced on a regular basis that says, hey, maybe this is a problem? Maybe they should come see someone like you?
43:53
Yeah, so that’s more so chronic issues that aren’t going away with the standard PT or Western medicine, treatment. And then repetitive issues that constantly come back. Those are the ones that I see the most.
Brett Scott 44:09
Okay. Another big one I’ve seen recently to is thyroid disorders and people so like my girlfriend is someone she just got diagnosed with Hashimoto syndrome, or disease. And it’s no, I don’t think there’s any coincidence that it happened when there’s been a high state of stress in her life dealing with different things that she has to deal with in life, but even sometimes, like, something will happen, you know, it could be something with dealing with different aspects, but like, one ear will turn bright red, it could be that I, you know, didn’t do the dishes, or forgot something, or you know, sometimes like she used to get these issues where like, some stressful stimulus would be put upon her and like, her skin would get all blotchy and break out and types are these things that you’ll typically see that’s other people dealing with do?
45:06
Yeah, I can. Yeah, so definitely see that type of stuff. Especially when there’s the autoimmune component there. People come in for that, you know, someone’s ear just turns red there, you don’t usually come in to see me. But yes, it was with the autoimmune as well. A good majority of my patients have thyroid issues. In the, in the book written by brawl, who’s the founder of visceral manipulation, he correlates thyroid issues to issues with your mom or yourself as a mom, usually. Yeah, so that’s, and then that leads always down a rabbit hole, which is interesting, I find so many times that people are dealing, so if they have children, that whatever age their children are, if their child’s 14, or eight, that there’s something that happened in their life, at around that age, that they didn’t process and then they get symptoms, and they end up coming in. So I had someone come in recently, with every time she turned her head to the right, she got dizzy, and like a little off balance, and then it was fine. And she had, you know, the Epley maneuver for BPPV. And it didn’t do anything. And so I was working with her. And it came down to the fact that she she was always surrounded by boys growing up, and it didn’t feel safe for her to be girly, and play dolls and Barbies. And her daughter was the age that she was when she kind of felt that and so it was interesting to kind of walk her through that and try and help her feel safe enough to be like her girly self. And allow that part of her to come forward without being scared that she’d be rejected. If that if that was, you know, what she presented with? We all need to you know, we’re, we’re social creatures, human. So we all have this drive to need to fit in and to be accepted. And sometimes that leads us to kind of shut down or abandon part of ourselves. And then, you know, while it might not, it doesn’t result in symptoms when you’re eight years old, usually, but you keep that suppressed, you know, for 45 years. And then you have a kid who’s eight who’s allowed to be girly. And that kind of resurfaces.
Brett Scott 47:26
Interesting stuff. So on the piece with thyroid there, too, we see a lot of people now that have thyroid disorders. So I mean, the correct me if I’m wrong, but the thyroid gland is part of like the adrenal cortex. Yeah, adrenal system. So do you think any of any of that has to do with just how high of a stressful lifestyle we all live? Now, that’s very different from what it used to be years ago? And do you think there’s ways to maybe prevent some of these thyroid disorders from happening, um, we’re just pumping thyroid hormone all day to keep up with
48:12
every day, every morning when I wake up the thyroid as well. So I do think that if we can, you know, the schools now are much bigger on social emotional learning than they were when I was growing up. And I think as the generations that have had social emotional learning, from early childhood, like, my kids know what the amygdala is not because I taught them, but because they learned at school. So, you know, as, as I think that generation grows up, I’m hoping that we’ll see less of this stress, but we’ll, we’ll have to see. But I don’t think that you know, you know, once the cellular changes have occurred, they’re harder to reverse. And that’s why you take thyroid for the rest of your life, like I probably will. But I think if you can get them before the stress levels under control before the cellular changes occur, then you have a higher a higher likelihood that that you won’t have all these issues. So I think that social emotional learning pieces is so huge and and very needed. And I’m glad to see that at least that’s the public school my kids are in our are doing it every week.
Brett Scott 49:24
That’s really cool. I didn’t know that we’re really doing that in schools yet, but definitely a piece of it. I have seen more of a push of getting kids in sense with being more in touch with their body like right, my girlfriend’s daughter, they do a lot of things on like working on their growth mindset, and, you know, coping with different types of stressors and things in life which and she has learned a little bit about the brand and different eras of and she’ll come home with like, oh, I learned about all these different things today. So it can be kind of cool to hear her. Tell me about you know, different Parts of the brand and digestion and everything else to which I don’t remember really getting much of when I was in school,
50:04
I think it’s it’s interesting how generations change, you know, I think our generation, I think it might be a little bit younger than me, but our generation was kind of the you just make it work, it doesn’t matter what you need to do, you need to make it work. So if you have to work harder if you have to, like stay up all night, and so we were at least, maybe that’s my just my family of origin, but I was taught to just push through all the time. And I know many people my age and 40, that especially moms that were taught the same. So I think that as you know, every generation tries to fix what was wrong in that one, but the next one, so I’m sure we’ll do something different, different, that will be wrong. But, you know, we’re trying to give our kids the accommodations that they need, so that they can be successful without having to kill themselves to get there. And so I’m hopeful that that will, we’ll see maybe a little bit of a change there, and maybe some decline as a generation grows up. But
Brett Scott 51:11
yeah, my parents favorite word growing up was suck it up.
51:16
Buttercup, I can’t even tell you how many times I’ve heard that. Yeah.
Brett Scott 51:23
Yeah, so there’s probably lots of things I’ve learned over time, that maybe not be the best coping strategies for things, because I think a lot of us have, but we just don’t, a lot of people haven’t been told these things yet. Either that like, hey, some of these past things are coming back. And this is what you’re dealing with now. And we have to be mindful of like, going back and processing some of these things, and facing them in some type of way. And granted, I’m not the person to do that with them. But, uh, you know, for people that have, you know, high levels of stress, anxiety, and they have, you know, thoracic, upper back pain or neck pain, we need to address your breathing, I need you to do some type of mindfulness or meditation type practice, and learn to control those things. And people like, I thought, you’re just gonna, you know, rub me down and give me some exercises. And, you know, tell me how to warm up better in the gym. It’s like, well, yeah, maybe that would help too. But we can’t treat this if you’re just in this state. So if So for people that don’t know, a lot of people that have anxiety, are just they’re very highly stressed all the time. They sit in the state of this, like, hyperventilated state where the ribs aren’t moving, because we’re not getting a full inhale and exhale out of our lungs. And so we could do all the manipulation of soft tissue and mobilization of joints in the worlds. But you know, one of my mentors said, if, if we’re doing this, we’re banging our finger on her head, that hurts, and we don’t stop doing that and change it, that’s gonna come right back. So if we just do this, let you walk out the door, and don’t address some of these other underlying problems with it, we might be a little more stuck for a little bit longer of a period of time. So it’s just interesting to see when patients come in with all these things. And I tell them something very unexpected from what they were expecting. But usually we’re able to work through it. But Sarah, is there anything else you have for us today? It’s been pretty interesting, getting through all this stuff, and talking through some of these things. And I think it’s definitely eye opening to patients. But anything else you wanted to put out on the table for us? I can’t think of anything. Okay. I was actually wondering, just for myself as a provider, how did you as a PT get into food sensitivity testing and leaky gut testing?
53:41
I mean, do do I use? Or like, lab? Or
Brett Scott 53:44
is that something you you use, like a third party to do? Or how do you or is that something you provide like in your office,
53:52
so it’s a blood spot testing. So it’s a fingerprint. So it’s not a lab draw. And it’s a kit. So you get the kit, you do the fingerprint I use, every patient can take the kit home and do it if they want to, or if they want, I can do it in the office for them. But blood spots on a card, I think it’s five blood spots from a fingerprint, you have to fill the circle, and then you send it in and they they test it and send the results back.
Brett Scott 54:16
Okay, and so from there, do you so do you use this with all your patients too? Or is this something you use?
54:23
It’s not it’s, it’s not cheap. So you know, it has to be and not everyone needs it. So it’s definitely not something that I use with all my patients. But if a patient is having, you know, patients having persistent post concussion syndrome with brain fog issues, and we can’t figure out you know, they’re not responding to treatment, and usually they’ve seen standard PT before they see me. So you know, they’re not responding. Nothing’s getting better than we’ll definitely test for food intolerances or food sensitivities. And sometimes that is the missing piece. And then once they take those foods out that are causing either an A or and acquired immune reaction in the body. When you take that away, then that systemic inflammation decreases and then the brain is able to function easier. So not everyone, but I do find it very useful.
Brett Scott 55:14
Okay, I guess we’re not done, I have a few more questions. With concussions, what are some of the big food sensitivities you find, because I’ve had a couple people like it just based on my own personal experience. And what I’ve been told and read up on is like gluten, dairy and eggs are like the three big inflammatory triggers for people. So most of my concussion patients now that we’ll see, I will have them eliminate those things. And four out of five times, symptoms start improving just from that alone. Yep,
55:47
so those are definitely the big three, especially Gluten is a big one. Dairy is also big egg is huge. And people don’t really realize that because the white of the egg has antibodies in it that protects the yolk. So if you introducing these foreign antibodies into your body into your system every day, it can definitely affect affect that gut brain connection there and create some inflammation, because your body’s like, what do we do with these? Where did these come from? But I find you know, that’s why I like the testing, though, because somebody had bananas the other day, and I as a level four, which is the highest level, like lots of acquired immunity reaction to it. And I was like, oh, that’s surprising. I would have never guessed banana is never in my life. But I’ve been like, I think it’s bananas. So it’s, that’s why I really like the testing, because it just gives you a bunch of common foods that you can you can take out if they’re aggravating you.
Brett Scott 56:43
Yeah, a lot of people don’t realize what foods are extra sensitive to like some can give us like some bloating and digestive type issues. But there’s a whole lot of physiology that goes on to that. I think, with food sensitivities, too, we don’t always see them until maybe two to three days later. Right? It’s not like an allergy where it’s like, oh, I ate, you know, an almond or peanut and my lips swell. It’s three days later of like, you can’t really be able to correlate that easily with yourself of like, what different things that I eat three days ago or two days ago, or maybe even a day ago to find that. So that’s very interesting that you do that. But I’d like to get sent me the
57:29
analogy is an IGE antibody response. And then a sensitivity is an evolved and acquired one as an IgG antibody response. So different antibodies, different responses. One is low level systemic inflammation, so it might take a few days for you to notice the symptoms. And the other one is obviously the immediate anaphylactic eyes. Blown angioedema.
Brett Scott 57:52
Yep. I don’t know why we don’t do more food sensitivity testing. I just had a patient that was being treated for RA. Rheumatoid arthritis. And like she was on either humera or Edinboro. And she just she didn’t have all the common sides, like something wasn’t adding up. Like she was having this chronic plans, pains. She didn’t really have like, the flare is all that bad, but just chronically fatigued, brain fog, couldn’t think straight. Should have joint pain. But wasn’t in all the joints you would expect with RA. And I was like, you know, you need to go see the functional med doc and, and she went to see one. And it turned out she just had an egg allergy. And you know, this girl has been on these meds for a couple of years now strong meds. Yeah, they’re very strong meds like immunosuppressants that like, you know, even during COVID. It’s like, should I be taking these? Because like this, you know, we don’t know what it’s doing back in 2020. But it’s like, Why didn’t anyone just look at these things before? Why don’t we just slap these, these medications at people and say, Yeah, you have rheumatoid arthritis. Now we have an egg allergy. And now she’s off all the medications. She’s living a perfectly normal life back to normal, like, doesn’t need PTO time doesn’t need any of these other things, because it was just something systemically underlying that she was eating on a daily basis and had no idea that she had a sensitivity to it. Right? And it’s just so what is what is the company use us to do it.
59:33
KB Mo, is the company and I liked them because some of them like if you do what I think it’s everlywell online, they just measure IgG antibody responses. So if you eat something every day, it’s likely to come up positive just because you have repeated exposures to it. But the one I use measures the IgG antibody response and also something called the C three D pathway so it measures not just innate immunity, it measures acquired immunity to the foods as well. So you get less false positives with that one. And it also measures the Zonulin, the occlusion and measures for Candida as well. So you get an idea if you have some overgrowth of Candida if you have some signs of leaky gut, and then also the food sensitivities
Brett Scott 1:00:23
are interesting. So when when do you decide to use some of these food sensitive tests? Like what is someone dealing with it? You’re like, you know what, let’s do a food sensitivity test.
1:00:34
I see a lot of patients with SI Bo that have done like, series of treatments without relief. And so a lot, I will always recommend it for that and say, well, let’s see if you know that bad bacteria is just constantly over growing because your gut is constantly inflamed. post concussion syndrome is a big one. And then if they have chronic pain that’s not improving the way we thought it would, I will often go to food sensitivities to see if there’s some underlying systemic inflammation from that.
Brett Scott 1:01:07
Is that do you see a lot of food sensitivities to with like, low back pain and things? Mm hmm.
1:01:14
Find that low back pain has a lot of correlation to the mesentery which is the root of the small intestine, so I treat that a lot with low back pain. Okay,
Brett Scott 1:01:26
interesting. Well, Sarah, thank you very much for your time today. We do get to wrap up here, but where can people find you?
1:01:35
I’m on my website is body and mind pt.com. And then I’m on Facebook, Instagram, Tik Tok. I’m in Windham, New Hampshire, if people want to come see me in person. Alright. And
Brett Scott 1:01:47
we’ll include all that in the show notes here, too. So, again, thank you for coming on. And I think I got a steal. I’ve been meaning to come in and see you for all my stuff that I’ve been dealing with and see what improvements we can
1:01:58
now because I’m looking for June.
Brett Scott 1:02:00
Yeah, I gotta, I don’t even know that I got my whole schedule. It’s like, every weekend is something we got meats, competitions, business conferences, and everything else. So it’s like, I got to try to figure out time for myself to because
1:02:14
take care of yourself, so you can keep taking care of your patients. Well, yeah,
Brett Scott 1:02:17
I know. I’m doing my best over here, but I will. I’ll fill out my form sometime soon. Because I want to come in because I’m just curious what, how it all works myself just out of my own curiosity, but also to help some of the things I’ve dealt with. So again, thank you for coming on. And no problem. And for our listeners, I have no idea who I have my next guest coming on, but I’m sure it will be an interesting stuff. So thanks for listening.
