The Berman Method
The Berman Method
Episode #177: Big Event Update and Meniscus Tears
Is the medical industry truly prioritizing your health, or are there hidden motives at play? Join us, Dr. Jake Berman and Jenny Berman, PA, as we pull back the curtain on conventional medicine's reliance on pharmaceuticals that often serve corporate profits more than patient wellness. We challenge listeners to question the standard medical advice and advocate for a more holistic approach. Drawing from our experiences in both the American and Canadian healthcare systems, we stress the importance of treating health problems at their root, rather than merely alleviating symptoms.
Ever been told surgery is your only option for a meniscus tear? Think again. We unpack the common misconception that all knee issues require surgical intervention. Instead, we argue for the benefits of physical therapy, which targets the root causes like muscle imbalances around the knee. By tackling these foundational issues, you can improve long-term knee function without the risks associated with surgery. We explore why understanding these imbalances is crucial, not just for knee health, but for overall physical resilience.
Our episode doesn’t stop at health advice. Celebrate with us as Jenny achieves a back squat personal best just nine weeks postpartum, a testament to the power of proper form and efficient movement. We highlight how small errors in movement can accumulate over time, potentially leading to injury. With video analysis and expert guidance, you can pinpoint and correct these form slips. Before wrapping up, we express our gratitude to our listeners and invite you to explore additional resources available through our website and social media platforms.
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This is the Berman Method podcast, featuring Dr Jake Berman and physician assistant Jenny Berman. We are here to treat problems and not symptoms. Disclaimer this podcast is for entertainment purposes only and not to treat anyone or to give medical advice. If you are interested in any information that we are giving and would like to use this for yourself, we recommend that you contact your primary care physician or reach out to us and ask us questions about yourself specifically. Enjoy, can you hear?
Speaker 2:And we are rolling. Yes, I can hear you.
Speaker 1:But can you hear Walker snoring on the microphone?
Speaker 2:I don't think his snore is going to make it all the way to the microphone.
Speaker 1:It's pretty loud.
Speaker 2:It's loud like out here, but it's not loud in the microphone.
Speaker 1:Okay, he doesn't have sleep apnea. He's just snoring because he's a little congested at the moment thanks to his two bigger sisters.
Speaker 2:Yes, the joys of having multiple kids in daycare. The Berman Method Podcast Treating problems and not symptoms. Dr Jake Berman here with my beautiful co-host.
Speaker 1:Jenny Berman, physician assistant.
Speaker 2:And our sleeping slacking on the job.
Speaker 1:Sidekick Walker Ryan.
Speaker 2:Good morning.
Speaker 1:Happy Monday Happy.
Speaker 2:Monday, happy Monday. It should be Monday when you're listening to this. You should be listening to this as soon as it comes out, to get your week started.
Speaker 1:Never miss a Monday.
Speaker 2:Never, ever miss it. We are David going against Goliath, goliath being the corporate medical system, the insurance companies, health insurance companies, big Pharma. We do not believe they have your best interests in mind. They will choose profits over patient outcomes every single time. Not a single pharmaceutical in the whole entire world is designed to treat the actual problem, opposed to symptoms. I have to laugh every time I watch a commercial where it's like wow, look at the eleventy billion side effects from this one magical I'm doing air quotes right now magical drug to treat psoriasis, to treat Crohn's disease.
Speaker 1:Yeah.
Speaker 2:I'm like what the hell?
Speaker 1:Those are the most common that we see on the television right now Psoriasis, plaque psoriasis, crohn's ulcerative colitis. Just take this pill. That's going to give you vitamin deficiencies.
Speaker 2:And hopefully your symptoms get better sometime between three months and 18 months and in the meantime hopefully you don't have a stroke and die.
Speaker 1:Right right.
Speaker 2:I mean we should do a whole entire episode on the side effects of these drugs.
Speaker 1:Like actually slow it down to a normal pace of speaking and see how long the list is like how many minutes it takes.
Speaker 2:I bet you we could go through five minutes if we set it normal speed.
Speaker 1:We should try it, I'm really interested. Because you don't realize how fast they speed it up when it comes to. I mean, you know they're speeding it up, but you don't realize how fast they're speeding it up.
Speaker 2:Yeah, it's the same thing as car salesmen on the radio. Right at the end of the commercial they speed it up to 17 times speed for all the fine print. Right but this is the deal of the year, right? Yep, this is the drug of the year, the drug of the century. It's going to make your life so much better. I almost said cure, but it's not going to cure anything.
Speaker 1:It's not cur cure anything. Yeah, I can't use that word.
Speaker 2:So here we are on another episode of the Berman Method. We've been getting a lot of random people coming up or finding us through this podcast, so it's gaining traction. 180 episodes later, we're gaining traction with the general population and it's really starting to resonate. People are getting smarter. They're getting more educated. They're taking it upon themselves to educate themselves on their own health care. You cannot take the advice from your general practitioner as end-all be-all. Those days are gone, maybe back in the 50s, not these days. You cannot take what they say as the end-all be-all. You have to question it, and I'm not saying that they're malicious. I'm just saying you have to know what their expertise is. General practitioners are experts in referring out. It's that simple.
Speaker 1:Right.
Speaker 2:You come in there with a cold or I don't know. Jenny, you'd do a better job because you went through it.
Speaker 1:Oh yeah, I mean, it's something as simple as coming in for a UTI and they're checking your urine and giving you the prescription for the UTI, but then not following up to make sure that the antibiotic actually worked for the UTI. Or if you have recurrent UTIs, they're just going to send you to the urologist instead of helping you to figure out what the actual problem is, and it's something against the primary care. As much as we talk about this, it is related to what insurance says they can and can't do. That's the biggest issue here.
Speaker 2:You know, what's funny about this whole thing is we're in snowbird season now and we get a ton of Canadians that visit our practice, that visit Southwest Florida and visit our practice, and the amount of times that I'm having the conversation with a Canadian and they're the ones that say everybody up there is a specialist. You go to somebody for knee pain and they just want to treat the knee. They don't want to treat the ankle or the hip. You go to them for one diagnosis and that's the only thing they'll look at. Nobody will look at the whole entire body or the whole entire picture and it drives them nuts. It's the same thing here in America. We just accept it more here in America. So that's what we do Look at the whole entire picture.
Speaker 1:We, as in Berman Golf, berman Physical Therapy, berman Health and Wellness, looks at the whole body.
Speaker 2:Yes, berman, berman Inc. Yes, we look at the whole body. Today I want to talk about knee issues and I want to get into that here in a minute. However, we're right in the heat of seminar season. Yeah, I mean, we are cranking them out right now. You were at Royal Palm last week. I was at the Maddox last week. Holy cow, if you don't know what the Maddox is, it is the private club that is across from Celebration. Yep, rebecca, yep, put it on. That place is over the top. Talk about nice, very nice, amazing people. Thank you so much for having us out, scott. That was amazing. This was my second year. Jenny, you're going to be going there in two or three weeks, march 19th.
Speaker 2:Yes, if anybody listening wants us to come to your club or your country club and present and do a talk, a PSA public service announcement. You got to let us know now because we are booking booked. We're booked, we'll have to squeeze it in.
Speaker 1:Absolutely. And our longevity event with keynote speaker Dr Carolyn Sederquist is on February 15th, so coming up this weekend it is at the Hyatt House of Naples. Dr Sederquist is going to be speaking on the metabolism, blood sugar, metabolic dysfunction. I'm going to be speaking on gut health. We also have a panelist of four providers, so myself, dr Cedarquist, jennifer Linguidi and Ava Elson, who are all going to be on a question and answer panel for you guys. We're all functional providers, more holistic base, and we are going to allow the audience to ask us questions specifically and learn a little bit more about holistic medicine and what can you do to get yourself off of some of the medications that you're taking. So really excited for you guys, the audience, to be able to ask the questions and get the answers from the four panelists after Dr Searquist and I speak.
Speaker 1:The last day to sign up for tickets is February 11th. So last day to sign up, just a couple days away, february 11th. To sign up for tickets you do have to reserve a seat. They are free seats and you can upgrade to the VIP seats. So which comes along with a little extra extra. So definitely check out the link in the show notes. Again, february 15th. 930 is check in 10am the event actually starts. It goes until noon. The last day to buy tickets is on February 11th, or at least reserve your seat for a free ticket, but you must have a ticket to come.
Speaker 2:So exciting.
Speaker 1:Yeah, we're excited.
Speaker 2:Yes, make sure you bring a friend. This is gonna be fun. Yeah, we're excited.
Speaker 1:Yes, make sure you bring a friend. This is going to be fun and Dr Sierkos is awesome. She was my. If you haven't listened or don't know. She has been my mentor for the last eight years really. She helped me work through my own health journey as far as my gut health issues and my infertility issues that we had. She was a huge help for that. She just has really mentored me a lot.
Speaker 2:And she's exciting to listen to. She's exciting to be in the same room with. She's got so much positive energy. Phenomenal communicator, nationally renowned I mean. She's been on all sorts of talk shows.
Speaker 1:Dr Oz yeah, she was on the news around locally in Southwest Florida for a very long time Every weekend did a little news clip. Yeah, she's spoken around the country for peer encapsulations and several events around the country.
Speaker 2:Yeah, so super excited for this. Get your tickets. Do not wait, they are selling out fast. Good. Excited for this. Get your tickets. Do not wait, they are selling out fast, good, yeah, okay, switching gears.
Speaker 2:I want to talk about knee pain today, just because it seems like everything comes in waves. This week or last week we got a ton of calls. Actually, the past two weeks we've gotten a ton of calls about knee pain and a ton of people saying weeks, we've gotten a ton of calls about knee pain and a ton of people saying they've got a meniscus issue. And if it's not a meniscus issue, they've got a bone on bone issue and they're trying to avoid surgery, a knee replacement. So I'm like, okay, come on in, we will know within 20 minutes if there's a way to prevent surgery or not. Now this is the thing that I want everybody to take away from this, because if this is not your expertise, you don't know what the problem is. You know your knee hurts and you got all these things that pop into your mind.
Speaker 2:Is it a meniscus? Is usually the first thing that people think as soon as you have knee pain. Most people think, oh, I have a meniscus injury or I tore my meniscus. Here's the black and white of it. Oh, I have a meniscus injury. Or I tore my meniscus. Here's the black and white of it. And I will argue till I'm blue in the face on what I'm about to say, for two reasons. One, because I've seen it clinically in my practice for over 10 years now, since I've been in my own practice, not following anybody else's rules, doing it my way. For the past 10 years I've seen this. But number two, evidence-based research has proven this time and time again. Now this is for meniscus issues.
Speaker 2:You can have a meniscus tear and never need surgery if you do the right rehab from it. Now let me clarify, let me say it differently the only time that you ever need surgery for a meniscus tear is when it tears off the meniscus, literally tears off of the bone or the cartilage and is floating around the knee joint. And you know that this happens because you'll be fine walking bending it. Then the next second you're not fine. You cannot bend it, you cannot straighten it. It is literally locked. Remember those words locked when the only time that you need surgery for a meniscus tear is when your knee locks. That means it's ripped off and it's floating around the joint and you got this, this free off and it's floating around the joint and you got this free floating object that's floating around and then occasionally it finds the wrong place or the right place, however you want to look at it, and it physically locks your knee joint. It's excruciating. You cannot straighten your knee, you cannot bend it. It is literally locked there until it frees up again. That's when you need to have surgery for a meniscus tear. If you don't have that issue, please, please, don't have surgery, because here's what's going to happen You're going to go for an orthoscopic surgery and the surgeon's going to say there's, this is no big deal at all, they're just going to go in here with this little camera and they're going to trim it and take it easy for two or three days and then you'll be fine. They never tell you to go to physical therapy afterwards, they just don't.
Speaker 2:And it's like what the hell? Why did the meniscus tear to begin with? This is the important thing A meniscus tears because there's too much tor. Important thing A meniscus tear is because there's too much torsion on the meniscus. Think about it your torsion, the bottom part of your knee is rotating one way and the top part of your knee is rotating the other way. That's torsion.
Speaker 2:Now, the reason why torsion happens is because there's too much compression on the knee joint.
Speaker 2:The reason why torsion happens is because there's too much compression on the knee joint. The reason why there's too much compression on the knee joint is because you don't have enough muscular support around the joint 360 degrees. 99.9% of the time when you tear a meniscus, it's because the quads are overfiring the quadriceps, the big muscles on the front of your thigh. Those muscles are overfiring compared to your glutes, your ass. Your ass needs to fire just as much as your quads to provide equal support to the knee front to back. But if your quads are doing the majority of the work because your glutes are not doing their job, that's going to increase the compression on the knee joint. Then you go to twist on your planted foot. I'm standing on my left leg and I go to twist to my left. That's a plant and twist motion. That's going to increase the torsion on the knee joint and that's why a meniscus tears. Now you can go have it orthoscopically trimmed and cleaned out, but it doesn't fix the reason why it happened to begin with.
Speaker 1:And when you go and have it trimmed and cleaned out, the cartilage just doesn't regrow. So you're taking out the cartilage that's there. When you have it trimmed, it's not fixing anything. It's not when you have it trimmed. It's not fixing anything. It's not giving you new cartilage, it's not giving you new cushion, it's not giving you the ability to grow that cartilage back. It doesn't grow back, so they're just scraping it out and not fixing the problem.
Speaker 2:Exactly so. The reason why I can say this so confidently that you don't need to have surgery for any meniscus tear unless it is torn off and floating around in the knee joint, causing the knee to lock is because they've done multiple studies where they're interviewing people who have had orthoscopic surgery for meniscus tear orthoscopic surgery for meniscus tear and then they're interviewing people who have not had orthoscopic surgery for meniscus tear and they just chose to do the conservative treatment, which is physical therapy. And they're looking at these people at six months, 12 months, 18 months, two years, three years down the road and well over 90% of the people that have chose to do the conservative route are reporting higher levels of function than the people that had the orthoscopic surgery. So, yes, it's a simple surgery in the grand scheme of surgery. You go in there with a little tiny camera and a little tiny mechanical scalpel on the end of that thing and they trim it out and you come out and it's relatively a simple surgery.
Speaker 2:But it's a surgery treating symptoms, not the problem that caused the symptom, and that's why these studies are showing time and time again that the people who chose to do rehab instead of surgery are reporting higher levels of outcome, higher levels of functionality at six months all the way there's three years out than the people that did have surgery. And I'm only saying three years because they're not going, they're not following these people longer than that. Why would they? They consistently reported higher levels of function. So this is really, really important. If you have a meniscus tear, it doesn't mean you have to have surgery unless your knee locks. It is black and white. There's no gray area. What you need to do is you need to get the knee completely straight, pain-free and the glutes firing. When you do that, the knee pain goes away, regardless if the meniscus is torn or not.
Speaker 1:And it's very difficult to know if your glutes are firing without seeing the right provider and the right therapist to help you figure out how to fire glutes and to feel that they're actually firing appropriately. Even someone like me who was a gymnast for 18 years and has lived physical therapy and is married to a physical therapist and has a physical therapist in her family as a sister, I'm surrounded by it. I've exercised my whole entire life. I mean, even after gymnastics I was so-so on exercising for about a year until I got my mindset back in the right place but then went right back into very intense and heavy exercising and I still can't always feel if my glute is firing appropriately. So you have to see the right type of therapist, the right type of provider to help make sure that you're actually using your glutes, your butt muscles, the way that you should be.
Speaker 2:Love it, absolutely love it, and it never, ever ends, meaning that you need to have consistent coaching on a regular basis if you want to maintain it. Just because you come see me, for example, and we go through some sessions and you're like, oh, I know what it feels like to fire my glutes now, I'm good to go. I'm going to go do my leg day and my squats and my lunges. I'm good to go. I'm going to go do my leg day and my squats and my lunges. I'm good for the rest of my life. No, you're not Six months later. You need to come back in minimum six months, at least one month, ideally.
Speaker 1:Yeah, I mean even us. We have to check each other on a monthly basis for sure, and things make it change right. So I had a baby. That was a pretty traumatic thing where I was carrying more weight and then I had an abdominal surgery because we had a C section. So those types of trauma will certainly change your muscle activation, or that mind to muscle memory, where the muscles remember how to activate appropriately. But even something simple like getting out of the car the wrong way and you tweak your pelvis a little bit and then the glutes aren't firing, things like that happen where you don't even realize it's happening on a day-to-day basis.
Speaker 2:You just hit a PR personal record for your back squat.
Speaker 1:You just hit a pr personal record for your back squat just last week. Yes, I did right. How much weight when I?
Speaker 2:tell you 150. Yeah 150 pounds 150 pounds on the bar back, squatted it jenny's personal record all-time best and she took a video of it and she showed it to me. She's all excited and I'm looking at it and of course I'm critiquing it and I'm going, wow, this is the best form I've ever seen you do with a squat.
Speaker 1:Nine weeks postpartum, and this is nine weeks postpartum, I'm going.
Speaker 2:This is absolutely amazing. I've never seen your squat look this good. There was one vulnerability though it looked really good. There was one vulnerability though it looked really good. However, as soon as she started to go up from the down motion, got to the bottom and started to go up, her weight shifted backwards more into her heels instead of the whole entire foot. When you go back there, it is almost impossible to have the equal firing of the quads and the glutes and the core all at the same time. It's really, really hard to do to make sure that the glutes and the quads and the core are all doing their job when the weight is more in the heels and not in the middle of the foot. Same thing is true if your weight goes the other way, into your toes. Now we've got increased compressive forces on the knee, joint quad dominant and it's just challenging.
Speaker 2:Now on video, you can look at that squat and go. That was awesome. Great job, Jenny, Good PR. She did not have any pain at all. She felt great, still feels great. But if Jenny keeps doing this for another month, another three months, another six months, at some point something is going to give, because she's not efficient right now. So she has me to say okay, when you come up, make sure you stay in the middle of the foot, not your heel, and that will make her less fragile, less vulnerable, so that she doesn't break down. So something doesn't tweak. Just because it doesn't hurt doesn't mean you're not doing something wrong.
Speaker 1:Right, yes, and that's 1000% true. And I record myself quite frequently, even this morning, doing deadlifts. I recorded myself to see from the back how my hips are shifting and seeing where I'm not firing or what point of the deadlift on the way down or on the way up I'm not firing appropriately. But when you aren't trained to that eye, even taking a video of yourself may not be so efficient if you're looking at it, but take a video of yourself and send it to your therapist that you're seeing and say, hey, what do you see in here? What can we correct? And then when you go in for your appointment, you guys can work on it.
Speaker 1:But again, it comes down to finding the right therapist to be able to help you to make sure these muscles are activating appropriately, even if your injuries were 15 years ago. My hip surgery I had hip surgery when I was 21 years old, so that was quite a long time ago and I'm still, to this day, having to work through figuring out how to get my butt muscles to activate appropriately again, even though I had the surgery. I had the repair I had quote unquote fixed the problem, but it's not really fixed because it came on because of this glute weakness that I had probably my whole entire life as a gymnast.
Speaker 2:Yes, exactly. If we use that video of your squat for an example, again I would put the numbers at it was 97% correct and it was only 3% incorrect. And the 3% was only you shifted into your heels instead of staying in the middle of your foot, so it was 97% correct. So we're talking about fractions like it's a hair, not perfect but the thing that you guys have to remember is, if it's 97% correct, that means that it's 3% incorrect. 3% turns into 4%, 4% turns into 6%, 6% turns into 10% and it just snowballs in the wrong direction over time. It doesn't always stay 3% incorrect, and when you can't see it, that's when things snowball in the wrong direction. So, again, if we didn't correct this, if Jenny didn't live with me and we weren't constantly looking at each other's form, she'd be, fine for three months, six months, maybe even a year, because she's very strong, jenny's very strong, so she can power through inefficiencies.
Speaker 1:It's called master compensator.
Speaker 2:Master compensator.
Speaker 1:And we all are. Every human is a compensator. You're compensating in some way and because your body is smart, it figures out how to adjust and get through what it needs to, if we're not 100%. But that's what leads to this percentage steadily increasing until it breaks.
Speaker 2:Exactly so. The biggest thing I want everybody to take away from this one is just because you have a meniscus tear does not mean you have to have surgery. And to be even more explicitly blunt, the only time you need to have surgery for a meniscus tear is when your knee locks. It physically cannot straighten, cannot bend, it's locked, it cannot move and it's excruciating. That's when you have to have surgery. If that's not the case, let's fix it.
Speaker 1:Right Doesn't mean, you're not having pain. You can still have pain, but it's not locking. So then, yes, let's fix it. Yeah, good.
Speaker 2:Like it.
Speaker 1:Like it. So find the link for our longevity event unlocking better sleep, better energy and reaching your goal weight, all while improving your gut health. Find the link to reserve your seats. Last day to book your seats is February 11th. The event is February 15th, and if you have any groups that you would love Jake or myself to come out and speak to so tennis clubs, rotary clubs, pickleball community, your just country club, your women's group, maybe just getting a group of 15 females at your house and letting me come speak about postmenopause, things like that, Let us know.
Speaker 2:All right. Share this episode like subscribe. Appreciate you guys. See you this weekend. Ciao for now.
Speaker 1:Thank you for subscribing on your social media and podcast platforms to the Berman Method Dr Jake Berman with Berman Physical Therapy and Jenny Berman, Physician Assistant with Berman Health and Wellness. You can find more information on our website wwwbermanptcom for physical therapy. Wwwbermanptcom forward slash wellness for the health and wellness. You can also find us on social media, Facebook, Instagram, and on your podcast platform, so be sure to follow us, like us, subscribe to us and, if you would like any further information, definitely visit our website and reach out to us. You may also find our free reports on the websites as well, where you can download this free information for yourself. Have a great day.