The Berman Method
The Berman Method
Episode #184: Symptoms Are Like Your Check Engine Light
Pain is your body's check engine light—but most healthcare approaches simply cover it up with medication or quick fixes. This fascinating episode unpacks the critical difference between treating symptoms versus addressing real problems through the compelling case study of a 77-year-old golfer.
Dr. Jake and Jenni Berman, PA-C dive into why our healthcare system focuses on symptom management rather than true healing. "One patient cured is a customer lost" isn't just a catchy phrase; it explains why pharmaceutical companies and many healthcare providers prefer treatments that manage conditions rather than resolving them. When watching medication commercials, have you noticed how they quietly mention "improvements after 12-18 months of use" in the fine print? These approaches create medication dependencies without fixing underlying issues.
The heart of this episode follows a high-level 77-year-old golfer whose impressive swing mechanics were being undermined by persistent back pain. Despite receiving physical therapy that included dry needling (which felt great temporarily), his condition never truly improved because the treatment targeted symptoms rather than the root cause. Dr. Berman explains how pelvic instability and muscle imbalances in the hips—not the back itself—were likely causing the problem.
Most people with chronic back pain attribute their issues to what shows up on MRIs—herniated discs, bulging discs, or degeneration—when these are typically results, not causes. The true solution lies in activating and strengthening the right muscles in the hips, pelvis, and glutes to create stability that protects the back. Whether you're dealing with back pain yourself or simply interested in better understanding how your body works, this episode provides invaluable insights into breaking the cycle of symptom management and finding real, lasting solutions to pain and dysfunction.
Subscribe to The Berman Method podcast for more episodes that challenge conventional wisdom and provide practical approaches to health and wellness. Visit bermanpt.com to learn about how their physical therapy and wellness services can help you address problems, not just symptoms.
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.
Speaker 2:And we are rolling baby with the Berman Method podcast, treating problems and not symptoms. Dr Jake Berman here, my beautiful co-host.
Speaker 1:Jenny Berman, physician assistant.
Speaker 2:Walker Ryan is in the swing snoozing snug as a bug in a rug. Here we are.
Speaker 1:Yeah.
Speaker 2:Yeah.
Speaker 1:Happy Monday, everybody, yeah.
Speaker 2:Yeah, yeah, yeah, you should have heard the mic check I did before I pressed record. Jenny said you should have recorded that mic check.
Speaker 1:Yeah, it was lovely. Actually, the whole time you were doing it I was thinking what is going through his head right now? Like, does he just like listening to himself? Are we really checking the mic? Does he feel like he's prepping for getting on the mic in Jamaica? I really wanted to know what was going through your head.
Speaker 2:I think that's probably not the first time you've thought those thoughts.
Speaker 1:Touche. Touche.
Speaker 2:Well, here we are. We are back for another exciting episode of the Berman Method podcast, focusing on treating problems and not symptoms and essentially doing everything the exact opposite way that big pharma and your health insurance companies do it, Because they are focused on treating symptoms, not your problem. They're focused on client retention, not curation. And remember, we can't say this enough One patient cured is a customer lost. Think about that.
Speaker 1:When it comes to big pharma.
Speaker 2:When it comes to big pharma? Yes, absolutely so. Why wouldn't they approve all of these pharmaceutical medications that do zero to treat actual symptoms? 100% of the pharmaceuticals that have been advertised through March Madness treat symptoms Right. 100% of them.
Speaker 1:A bunch of rheumatology and GI medications. That's all it is.
Speaker 2:Every single commercial is either rheumatology or GI. So you got ass piss or you got some itchy skin here. Take this drug that treats the ass piss or the itchy skin versus what actually caused it.
Speaker 1:Right and you have to wonder if you're getting put on a medication where your doctor says, in order to refill your medication, I must check your lipid panel and your liver enzymes to make sure they're not going crazy on this medication. That should trigger your mind that this might not be the best option for me.
Speaker 2:Well, nobody knows what that means. Nobody knows what that means. Yeah. And let's not even go down that rabbit hole, right?
Speaker 1:That's not what we're talking about today, not on this episode. Yeah, and let's not even go down that rabbit hole. That's not what we're talking about today, not on this episode.
Speaker 2:Okay, but here's the last thing I want to say on that topic is notice the next time you watch that rheumatology medication I think it's for moderate to severe plaque psoriasis Renvoke, revoke, renvoke, renvoke. 60% of the people in the case study saw noticeable improvements after 12 to 18 months of use is that what it says?
Speaker 1:that's the kicker I don't even think I've ever listened to that part they don't, I don't, they don't say it.
Speaker 2:You have to read the fine print. It's at the very end. It's the fine print. You have to press pause because it happens so fast and it's so small. I had to get my readers out to see it. After 12 to 18 months of use, some saw some improvements. Right.
Speaker 2:Right. So they're saying, listen, you've got to give us at least a year to give this thing a chance and how much could we solve in a year through lifestyle change? Yeah, but look at what they're doing. They're getting you into a habit of taking this medication once you take once.
Speaker 2:you take something for 90 days. It's just a habit. It's just another pill that you throw in. Look at your grandparents, look at anybody over the age of 80 that's got 20 plus pills they take a day. Good point, it's just a habit. Three of them are treating the same thing times five, so there's 15 of them.
Speaker 1:And I was just told to do it and that I have to stay on it in order to see the change. Good point.
Speaker 2:So, anyways, my rant is coming away Now it's time for me to eat a little bit of a humble pie here, because I actually screwed up and I want to tell a story about how I screwed up Not me personally, but I guess it is me personally because it was my team that this happened with. So technically it's me, I'm the leader of my team. I've got a client right now that I've been working with in the golf room and he's been with us just over a year and 77 years old, in great shape overall great shape, and I've been recording some of his swings. And when you look at this guy's swing, the way that he moves, he moves like a 40 or 50 year old. He's able to lag the golf club for all you non golfers out there. It's one of the most sought out after moves that you can in golf and it's usually reserved for the 20 to 30 year old body and he's able to do it. Plenty of swing speed, plenty of power. But he's got a back issue. He's got this nagging back issue that just never seems to completely go away, and I wasn't fully aware of this because I had a different guy on the golf team a year ago and different providers in the PT room a year ago and different providers in the PT room a year ago. But when he first came on into my golf world he had noticeable back issues then. So my golf guy who was on staff at the time Case you heard me reference him on the golf podcast a year ago he did the right thing. He sent him to the PT room to address his back issues. So here's where things went. Not as good as they could have gone, actually, not even close to as good as they could have gone.
Speaker 2:A year ago I was in a position where I needed to hire a traveling physical therapist. I didn't have enough staff to be prepared for this season influx, so I had to hire a traveling physical therapist and on paper she sounded great. The conversations that we had through the interview process were great, focused on treating problems, not symptoms. Manual therapy it was all great. Treating problems, not symptoms. Manual therapy it was all great. The problem occurred when I sent this golfer to her, or my team sent this golfer to her and he's a very high-level golfer. He's a high-level Physically. He's in better shape than most are at 77.
Speaker 2:And her technique was very generic. It was very cookie cutter-esque and I'll just go ahead and say it. She was big on dry needling. It was the number one intervention that she did throughout the time that she was in my office and 99% of her clients, the people that were on her schedule, loved it, absolutely loved it.
Speaker 2:If you've never had dry needling before, I highly recommend it because it feels amazing, because it goes straight to your symptoms. It goes straight to a pissed off muscle and gets it to be unpissed off or less pissed off and you get up off the table and you feel great. Problem is it doesn't fix anything. You have to activate the right muscles at the right time afterwards to make sure that that pissed off muscle doesn't get pissed off again. So here we are.
Speaker 2:We got this high level golfer who is being treated for back pain but we never really truly addressed the problem causing the symptoms. Every single time he saw my traveling PT that was on my staff. She's just treating his symptoms. So I say all that to fast forward to this past weekend. This past weekend I take them out for a nine-hole lesson, so a playing lesson. Whenever we're done, or whenever we're trying to translate what we're learning inside my office in the simulator room, we take it outside and we'll play nine holes and it's more of a teaching lesson, to try to translate it. And it was almost a complete waste of time because his back was just killing him the whole entire time.
Speaker 1:What was happening with his back, Like what were you having to do?
Speaker 2:Well, before I get into those weeds, let me tell you what his symptoms were. Okay, it was a sharp stabby spasmy type symptom and he could not get through the golf ball. So the backswing was doing okay, but the problem was he could not finish the swing. So he was either leaving everything out to the left or yanking everything to the right, because he's a left-handed golfer. So it just wasn't allowing him to finish the swing. So what I was doing was he had pelvic instability.
Speaker 2:This is 99.9% of the time why any aging person period has non-traumatic back pain, it's because of pelvic instability. So before every single swing I had to say fix your pelvis. Okay, now keep your core engaged, address the golf ball, keep the core engaged. But now what we did was we added three or four or five more thoughts during the golf swing. Which is any golfers out there listening to this? That's horrible. One, maybe two thoughts during the golf swing, not 10 or 15. The point that I wanted to get to here is that this is something that had just been trickling along for the past year and we never truly addressed the problem causing the symptoms, which is, I'm 99% certain that we've got an asymmetry in muscle strength and or endurance in one of his hips compared to the other side, and that's what's causing the pelvic instability and, essentially, his back spasming up and not being able to finish the golf swing. Okay, yes.
Speaker 1:I'm with you, so it's symptomatic. It's been a nagging issue.
Speaker 2:Yes, now here's the icing on the cake. There's a lot of people who have back pain, knee pain, shoulder pain that will live with it for years. They'll do stretches, they'll use ice or heat, or they'll take pain pills or they'll rest it.
Speaker 1:Or they'll go to physical therapy.
Speaker 2:Or they'll go to physical therapy because their doctor told them.
Speaker 1:Treating symptoms.
Speaker 2:Treating symptoms and say, well, I tried physical therapy and it didn't work. And then it gets to a point to where it's fine, it's fine, it's fine, I can live with it. I can do everything that I want to do, more or less. I just have to be smart. I can't golf as much as I want to, because I do have to rest. I can't exercise as much as I want to. I can't do this, I can't do that, but I can do most of everything I want to do.
Speaker 1:Or I can do it and just take some Advil and I'm all right.
Speaker 2:Exactly Until you can't, until you can't, right. So there will be a point to where it's not going to work anymore. There's going to be a point to where the wheels fall off and it's like what the F? I can't do it anymore, it's not working anymore. And this is the important part to note is that that day will come, 100% of the time it will come. So what we have to do is we got to make sure that we are trying to focus on the right things, meaning that paint is a signal. Paint is that little dashboard or that light on your dashboard of your car saying there's something going on here. You might want to check it out.
Speaker 1:Right the check engine light.
Speaker 2:The check engine light just came on. It might want to check it out. Right, the check engine light. The check engine light just came on. It might be nothing.
Speaker 1:Let's just drive it for another 10,000 miles, then we'll figure it out.
Speaker 2:Yeah or not?
Speaker 1:No, but if we think about it, when the check engine light comes on the car, we don't do that right. We take it to the shop and say what's causing this check engine light, let's fix this problem, because I can't drive it another 10,000 miles with the check engine light on. But when it comes to our body, we feel pain, we're like, eh, it's fine, I'm just going to take a little Advil, fix the symptom. Or better yet, I had a client just recently with this tennis elbow or golfer's elbow, and she's like my doctor gave me some prednisone. I'll probably just take that and see if that helps.
Speaker 1:And I said or we can not take the prednisone, that's going to spike your blood sugar and fix the actual problem. But the problem is she didn't know that there was a better option to taking the medication. So the point of what I'm saying is that pain response is your check engine light. We should be treating it like a car where we say, okay, let's fix this problem, let's figure out what's causing the problem. Let's fix the problem. Your body is your car, it is your vessel. You only get one of them. So when that pain response happens, think about it like your check engine light and let's figure it out.
Speaker 2:I love that. This is the analogy that we're using right now, because my check engine light has been on for three years.
Speaker 1:On your body or your car.
Speaker 2:On my truck. The check engine light has been on for three years, but I did get it checked and I do know what the problem is. I just haven't fixed it yet. It's the O2 sensor and the gas cap. Forgive me, mechanics out there, if I'm saying that wrong, but it's just a sensor. There's nothing wrong with the vehicle, and it would require me giving my vehicle to Chevrolet for at least a day. And when is that ever convenient in our lives? It's just not. So guess what I did with my check engine light.
Speaker 1:You just disabled it.
Speaker 2:No, I covered it with a picture. Oh my gosh.
Speaker 1:What not to do with your body.
Speaker 2:So I got a picture of my brother covering the check engine light. That's great. So every time I look at that picture I go you're reminding me that there's something I should be doing, right now but like we've always done growing up, I ain't gonna do it oh my goodness, that's funny right there, that is really funny.
Speaker 2:But here's the kicker. Let's get back to this kicker. So I'm talking to my guy yesterday and I'm like, listen, this is bad, let's get you in there. I'm going to change my hats from helping you with your golf swing to I'll put my PT hat back on, reluctantly. Put my PT hat back on and I'll try to figure out your back In my head. I'm going. I'm 100% confident that I know what your back problem is and that I can help you resolve this the right way. However, I could not say that to him because I knew that he'd be skeptical. So here's the words I said let's switch our next appointment from golf to PT. Is that okay with you? And the literal words out of his mouth is he goes well. I mean the literal words out of his mouth is he goes well. I mean I guess. I mean I got to be honest. I'm really skeptical. You know, I tried it in the past. I tried it in the past.
Speaker 2:Meaning that he tried me my name, my brand with the traveling PT who only focused on treating symptoms of dry needling. He tried it and it didn't work. But then three seconds later he goes but I've never had you actually do it, so let's give it a try. So it just comes down to skepticism, and if you don't believe something's going to work, why would you try it? That's the big thing, right there.
Speaker 1:Right, and not even. Why would you try it? Why would you not give it your all? I mean, we've had, certainly on our side too, some clients that come in and they say they're going to do this and we start making some adjustments, but they just don't trust the process. Then they're not a hundred percent in, then they're not going to get better.
Speaker 2:It's just not going to work. It's not going to work. The worst thing that you can do is not try something because you think that you already know the answer to that's the worst thing that you can possibly do and, admittedly, this was on me. He did trust me. He does trust me. The golfer I'm talking about right now trusts me completely. He's told me multiple times that he was, before coming and starting my golf program, he was strongly considering letting his Naples Golf Club membership go because he just couldn't golf anymore. His scores were getting worse, his back was bothering him and he didn't enjoy the game anymore because there was just no enjoyment out of it. So he was strongly considering letting his membership go and we were the last ditch effort to try to salvage his love for this game. So he trusts me. Here we are a year later. The guy's still spending money with me. I'm not cheap.
Speaker 1:And he's loving the game.
Speaker 2:Loving the game, but now we've got this back issue. This is the biggest thing the amount of progression that I've made with this guy, 77 years old, and I've taken videos of him and hopefully he signs the waiver allowing me to send this out to my list because I hope that you guys can see the screenshots of you know slow motion video of his swing. It's just absolutely amazing. I've never worked with anybody over the age of 70 that can swing the club like he does and the amount of potential that he has to play some really good golf for a really long time is through the roof. Has to play some really good golf for a really long time. It's through the roof. But right now we've got his back, just pulling it all away from him Like there's no chance that he's going to continue this game. There's no chance that he's going to get any enjoyment out of this game because his freaking back, but then you're going to fix it.
Speaker 1:So in eight weeks we're going to have a part two to this episode.
Speaker 2:Hey, siri, remind me in eight weeks do a follow-up episode on the Berman Method podcast about golfer with back pain. Try to avoid name-dropping too much.
Speaker 1:Awesome.
Speaker 2:She wrote it down.
Speaker 1:May 26th yeah, that day, I think yeah, we'll be in jamaica yeah, maybe we'll podcast from jamaica podcast from the islands mine with a video podcast for real oh man, I can't wait to grow my hair back out.
Speaker 2:Do some dreads.
Speaker 1:So we're not just treating symptoms. We need to identify the problem and treat the problem. The problem is a lot of people don't know how to do that.
Speaker 2:Yeah, back pain is the simplest one, and we'll wrap this episode up with this last statement here. Back pain is rarely ever due to herniated disc, bulging disc, degenerated disc, whatever you want to call it. It's rarely due to what you see on your MRI. What you see on your MRI is, 99% of the time, the result of something not happening in your hips, your pelvis, your glutes, because that's where the big power muscles are, that's where all the strength and stability should come from, which takes the stress away from your back.
Speaker 2:So most people with chronic back issues attribute their chronic back issues to what shows up on their MRI and so often it's just not true. You just need to be shown the right way, because it's not due to being lazy. You'll put in the work if you know what to work on and get the right way. Because it's not due to being lazy. You'll put in the work if you know what to work on and get the right muscles activated and then get those activated muscles stronger and the back pain 99% of the time goes away. Got it Good yes.
Speaker 2:So that was fun. All of you that didn't know we've got a golf business. Go to BermanGolfcom and check it out and like, subscribe, share this episode.
Speaker 1:Happy Monday. Ciao for now. 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.