Episode #213: The Real Cause How a Hip Problem Became an Achilles Pain

In this episode of The Berman Method Podcast, Dr. Jake Berman and PA Jenni Berman dive deep into what it really means to treat problems, not symptoms. They pull back the curtain on the frustrations of the modern healthcare and insurance system, sharing real-life experiences that highlight why quick fixes and symptom-chasing often fail patients.

Through personal stories—from Jenni’s years-long Achilles pain to the mindset shift that reshaped Jake’s entire approach to rehab—the conversation breaks down why pain is rarely coming from where you feel it. The episode explores functional manual therapy, objective testing, and the powerful idea that improving how the body functions ultimately leads to lasting pain relief.

They also challenge one of the biggest myths in healthcare: that pain is a normal part of aging. With eye-opening examples and plenty of perspective, this episode reframes how we think about movement, strength, longevity, and quality of life. If you’ve ever felt stuck in a cycle of treatments that never truly fix the problem, this conversation will change the way you look at pain—and your body—moving forward.

Check Us Out On Social Media - 

Facebook: @bermanwellness , @physicaltherapynaples, @Berman Golf 

Instagram: @berman_wellness, @bermanphysicaltherapy , @Berman Golf 

Youtube: Berman Golf, Berman Physical Therapy

TikTok: Bermangolf, Bermanwellness

Email us - 

drberman@bermanpt.com 

jenni@bermanwellness.com 

Check out our website - 

www.bermanpt.com 

www.bermanpt.com/wellness

www.bermangolf.com

Transcript

Fighting Goliath: Insurance And Profit

Speaker 0:01

And we are rolling baby with the Berman Method podcast, focused on treating problems and not symptoms. Dr. Jake Berman here, my beautiful co-host. Jenni Berman, physician assistant. We are David going against Goliath. Goliath being the corporate medical system, big pharmaceutical companies, the health insurance companies. They do not have your best interests in mind. They will choose profits over patient outcomes every single time. Who could even quantify the amount of time that you, Jenny, have spent on the phone battling health insurance companies over the past five years? What percentage of your life do you think that it's taken up?

Speaker 1 0:44

Too much of it. Too much of my quality life, for sure. I mean, just in the past six months, it's been, I don't know, 30 hours.

Speaker 0:57

Minimum 30 hours. Because think about it this way 30 hours you spent on the phone, but how much time have has thinking about it taken?

Speaker 1 1:06

Oh, yeah, yeah. And that's just for my own personal care, not even the fighting that I'm doing for patients.

Speaker 1:12

Yeah, I'm just talking about us, the Berman family.

Speaker 1 1:15

Personal care, Burman family. Oh yeah. It's just been crazy. Just to fight and fight and fight.

Speaker 1:22

It is insane. It's absolutely insane. And if we weren't talking about big number procedures, we just pay cash because we pay cash for everything, everything else. Yeah. I mean, we we pay cash for our teeth being clean, we pay cash for our annuals, we pay cash for anything that we possibly can.

Speaker 1 1:41

Yes. This is the first year we've actually had medical health insurance again in several years. Only with having Walker and the anticipations coming behind it. But yeah, for for that reason is that it's really not worth it. Like just pay cash for things.

Cash For Care And The Car Insurance Analogy

Speaker 2:00

And that was the biggest thing that helped us was to get over that mindset that just because you have health insurance doesn't mean that you should expect to use it because health insurance and car insurance are the same exact thing.

Speaker 1 2:12

Right.

Speaker 2:12

You have to have car insurance to drive in the state of Florida.

Speaker 1 2:16

Yes. You have to we learned you have to have car insurance for a car just to sit in your driveway.

Speaker 2:21

Oh my gosh.

Speaker 1 2:23

But anyways, keep going.

Speaker 2:25

Jeez Louise. Wow. Yes. So you have to have car insurance to drive in the state of Florida, but you don't use your car insurance to pay for an oil change.

Speaker 1 2:35

Right. Or a tire rotation. Or new tires for that matter.

Speaker 2:39

Yeah. We just spent a thousand bucks for new tires or fifteen hundred bucks for new tires. We didn't ask State Farm to pay for it or progressive, whoever we're using.

Speaker 1 2:49

I don't even think we use either one of those these days, but here nor there, that doesn't matter.

Speaker 2:53

Yeah. You don't expect your car insurance to pay for breaks or AC tune-ups. Right. You expect your car insurance to pay for something catastrophic where you got into an accident and the fees are going to be very significant. So you pay for it. Right. Or you ask them to pay for it. Right. That's what you're paying for.

The$27,000 Surgery Shock And Burnout

Speaker 1 3:13

That's for car insurance. And you would expect the same amount of health insurance, but that still isn't how it works.

Speaker 3:18

It still is not true.

Speaker 1 3:20

You walk in for a surgery and they're like, we'll pay $1,200 out of your $27,000 bill.

Speaker 3:25

What?

Speaker 1 3:28

That was a legit quote that we got.

Speaker 3:31

Oh my gosh. We could write an entire book on this past these past five years dealing with health insurance companies.

Speaker 1 3:40

Since having children, yes.

Speaker 3:41

I mean, it's just it's just insane. It's so it's so laughable. You have to laugh at it or we'll cry.

Speaker 1 3:48

Well yeah. I think I have cried many times.

unknown 3:54

Yes.

From Symptoms To Root Cause Mindset

Speaker 1 3:54

Okay.

Functional Manual Therapy Changes Everything

Speaker 3:55

So getting back into what we want to talk about today. Last episode, we talked about how did we do this mindset shift from traditional treat symptoms to treating problems? And we talked about how Jenni went through her own personal health issues in PA school, and led to us figuring out that gluten was the reason why she got deathly ill, lost 30 pounds in a week, was hospitalized for over two days, and left with zero answers. And this was the uh-huh moment for me where it's like, okay, now I get it, because at this point in time, I had been working with the last boss that I had, his name's Aaron Roblis out of Jacksonville. And Aaron Robliss is a certified functional manual therapist, which is arguably the most prestigious manual therapy certification that you can get in America and even the world. And this is what Aaron was certified in. And he was graciously treat uh teaching me how to treat using functional manual therapy methods, which are nothing like what I had been previously exposed to, which is your shoulder hurts. I would poke around on your shoulder till I found a tender area, then I would do soft tissue massage to that tender area, and then ask you to move it again, and you'd say, Oh, it doesn't hurt anymore. And I'd say, Okay, I did my job.

Speaker 1 5:25

Great. See you back in two days.

Speaker 5:28

Versus what I was learning with Aaron was one of the most explicit examples that I can remember is somebody had shoulder pain. And Aaron is working on this person's neck and upper back. And I'm going, What is he doing? Their shoulder hurts. Then after he was done with his manual therapy intervention, he asked them to move their shoulder again. And the patient goes, It still hurts. And he goes, I don't care about your pain. I care about what your body is telling me.

Speaker 2 6:03

Right.

Speaker 6:04

And this is what completely changed my whole entire outlook on therapy and rehab, is because he was not asking for subjective information, meaning like, does it hurt when you do this motion? What he would do, what Aaron does, is he does a specific objective test to see which muscles are or are not working, and then levels of and grading them on if they are or are not working. And then he would do his intervention and then retest those same exact measures. And if they got better, then we could say that the intervention was productive or successful.

Speaker 1 6:45

Right. Objectively.

Objective Testing Over Pain Reports

Speaker 6:46

Objectively. And here's the thing that I learned. I didn't know this at the time, but I know it now, Claire's day, is that pain and function are inversely related. Meaning that as your functionality goes up, meaning that you can move better, you're stronger, the body's moving more efficiently. Pain always goes down. And here's the kicker it's usually delayed.

Speaker 1 7:15

Right. It's not immediate.

Speaker 7:16

So as you get stronger and your body's working better, there's usually a delay from when the pain starts to get better. Now let's do a quick asterisk. This is regarding primarily non-contact injuries, meaning like there was no trauma, you didn't tear your ACL, you didn't get in a car accident, you didn't slip and fall. So these are specifically for examples where I woke up one day and my back was hurting. I was in the gym doing great, and then all of a sudden my shoulder started tweaking. So these are called non-contact injuries or insidious onset of pain. Insidious means that there is no real reason why it started. So as function goes up, pain always goes down. So that led me to quit focusing on your pain and just continue obsessing over what your body's telling me.

Speaker 1 8:13

Functionally.

Speaker 8:14

Functionally.

Pain Downstream Of Better Function

Speaker 1 8:17

And and you know that based on the movement and these objective tests that you're doing.

Speaker 8:22

Correct. So let's use you for another example. I mean, it's like we've got countless examples or opportunities to use you as an example.

Speaker 1 8:30

Look at me.

Speaker 8:31

When we first started dating, you had an Achilles issue.

Speaker 1 8:35

I did.

Speaker 8:38

It was right at the base of the heel, like right where your Achilles inserted into your heel, your left foot.

Speaker 1 8:46

Yes.

Speaker 8:46

And it hurt really bad. You described it as. Do you remember? Or did you block this out of your memory?

Speaker 1 8:54

An ice pick in my heel.

Speaker 8:56

Yeah, it felt like an ice pick, and you're like, it feels like it's ripping.

Speaker 1 9:00

Yeah, it does. It did. It did.

Speaker 9:02

It felt like it was ripping, and you described it as an ice pick right in the back of your heel.

Speaker 1 9:07

Mm-hmm. Not in the bottom of my heel, but on the back. And it was fat. Like it had it had a huge bump on it.

Speaker 9:14

Yeah, it was visibly bigger. Like you could palpate it and you could, oh my gosh, what is that? Yeah. So me being new to the world of physical therapy and only knowing about treating problem or symptoms, I'd keep massaging that area and trying to do some grasting techniques and myofascial release, and she's screaming and crying and saying this hurts like hell. There's gotta be another way.

Speaker 1 9:38

It was so painful. I was in a boot and on crutches for ever. I mean months.

Speaker 9:45

It was like the whole first half of our year that we were dating.

Jenni’s “Ice Pick” Achilles Story

Speaker 1 9:49

Yeah. I would get off of crutches and then back on them, and then in a in a boot and out of a boot and back in a boot, and it was just this constant cycle. Do you think it was a year?

Speaker 10:01

I it had to have been close to a year. It was a long time. It had to have been. Yeah. And we just kept treating it, treating the symptoms over and over again. And then the back of my mind, I'm going, we've got to do something about this because I don't want her to tear her Achilles because that's going to be a year rehab to do that.

Speaker 1 10:18

Right. And that's what it felt like. It was just ripping every day, every time I tried to walk or take a step or put a shoe on. Putting a shoe on was horrible.

Speaker 10:27

Yeah.

Speaker 1 10:28

Yeah.

Speaker 10:29

And then what ultimately ended up happening? Do you remember? I know it's a long time ago.

Speaker 1 10:36

I well, I remember going to the clinic you were working at in Destin.

Speaker 10:42

Yeah.

Speaker 1 10:42

And they started working on my scar, which is on the front of my leg. I have a very long, what is it like five-inch scar on the front of my leg? On my shin bone.

Speaker 10:53

Yeah.

Speaker 1 10:54

Which happened when I was in second grade. I had a surgery to remove um a cancerous birthmark. And the scar is it is very, very long, takes up the whole front of my leg. But I have no like I'm very scarred down. I have a lot of scar tissue underneath that scar, essentially just scarring, holding my skin fascia to the shin bone.

Speaker 11:20

Yes.

Speaker 1 11:21

So we started working on that.

Speaker 11:22

Yes.

Speaker 1 11:23

Releasing the front of my leg to help with the Achilles. Is that what you were thinking?

Speaker 11:29

Yeah. So the pain was in the back of your leg.

Speaker 1 11:32

My heel, yeah.

Speaker 11:33

Your heel. My Achilles. And then the scar is on the front of your leg.

Speaker 1 11:36

Yes.

Speaker 11:36

That's 12 inches away from the pain.

Speaker 1 11:39

Right. And very old. Like I mean that's 30 years old. Yeah, I had that scar since I was in the second grade. And this was how old was I at the time? Twenty-three when this started.

Speaker 11:51

Yeah.

Speaker 1 11:52

Yeah.

Speaker 11:53

So we started working on that. And super long story short, things started to progress. Right. Things started to get better.

The Hidden Scar And Systemic Response

Speaker 1 12:02

Working on the scar. Oh my gosh, I remember working on that. I would just sweat and sweat and sweat. Like it caused a huge stress response in my body while we were working on the front of my leg, the scar. And I wasn't even doing anything. I wasn't exercising. I was just laying on the table getting worked on, and my body was just sweating.

Speaker 12:23

It was freaking out. This huge sympathetic response where your body's just perspiring like crazy. Like just huge fight or flight response happening. But, anyways, we're treating something else that had nothing to do, or I'm sorry, wasn't even close to where the actual symptoms were.

Speaker 2 12:42

Right.

Speaker 12:43

And super long story short, this led to the pain starting to decrease. And it seemed to get better. And then we assumed that it was better. And fast forward, I get into Aaron's place and start working with him and learning functional manual therapy. And that's when we really found out that there was way more going on than even just the scar.

Speaker 2 13:03

Right.

Speaker 13:03

That's when we found out that that hip surgery that you had back when.

Speaker 1 13:09

Let's see, 2012, 20, the end of 2011, December 2011.

Speaker 13:14

Twenty end of December or December 2011, you had a left hip hip surgery to repair.

Speaker 1 13:21

Yeah. Labral labral repair.

Speaker 13:23

Labral repair. And what we found was even though she went through rehab, quote unquote, successfully, there were still some muscles in her left glue that were not doing what they should have been doing when they were supposed to be doing it.

Speaker 1 13:39

Yeah. Significant weakness in my left glute. Yeah. My left buttocks.

Speaker 13:43

Yeah, it just was not working at all the way that it was the right side was working.

Speaker 1 13:48

Or my left core, like my left oblique muscles weren't working either.

Glute And Core Weakness Revealed

Speaker 13:53

Right. So then we start addressing the issues in her left glute and her left oblique. And that's when things really skyrocketed.

Speaker 1 14:03

Yes. Because I was still having a lot of on and off. Like I couldn't wear certain shoes, even though the pain was gone and I was back to working out and I wasn't in a boot and I was walking at least without crutches. There were certain shoes I couldn't wear because some shoes would flare the Achilles right back up. Or certain, you know, I couldn't run. Forget running.

Speaker 14:21

Yeah.

Speaker 1 14:22

I don't think I ran for years because I was like, every time I run, my Achilles will flare up.

Speaker 14:27

Yeah.

Speaker 1 14:28

Until we started working on my glute.

Speaker 14:30

Until we started working on your left hip and your left core. And this right here is a perfect example of treating problems, not symptoms. She had Jenny had excruciating pain in her left heel that was chronic for years.

Speaker 1 14:45

Yes.

Speaker 14:46

And it wasn't until we started addressing the issues or the limitations in her left hip and her left core that it finally was fixed the right way.

Speaker 1 14:57

Right. And I ended up running a half marathon. The gate river. Mm-hmm.

Speaker 15:06

Yeah. Just by fixing things that were the real problem causing the symptoms. Right.

Speaker 1 15:13

The boot and the crutches didn't do a thing. Actually, it was probably worse.

Speaker 15:16

It made it way worse.

Treating Problems, Not Symptoms Pays Off

Speaker 1 15:18

Because then my left calf was weak. My left glute was even more weak because I wasn't using it for a year. Yeah.

Launching A Cash PT Practice

Speaker 15:25

Exactly. And this was my first explicit example personally, being able to see black and white the difference of treating an actual problem and not focusing on the symptom. And this is ultimately what led to me opening up my own practice. So fast forward, we get married in 2015, and we moved from Jacksonville down to Naples. And I open up Berman physical therapy in October of 2015. And right out of the gate, I open up with no insurance. I'm not taking anybody's insurance. And I'm going to specialize in functional manual therapy. And I'm going to be the greatest thing since sliced bread at helping people get out of pain because I'm the best manual therapist in Southwest Florida. These are all thoughts going through my head. Little did I know that I knew nothing about business and I got punched in the face real quick. And my parents are helping me pay my bills for rent because the phone's not ringing. So, anyways, that led to a whole nother set of weaknesses on my part as far as how to run a business. Right. But one of the best things that I learned during that time was how to really get good at identifying what a real problem is that's causing a symptom, because it was just me by myself in a little 380-foot square foot room and a patient.

Speaker 2 16:56

Right.

Speaker 16:56

And because my schedule was not crazy, I could spend as much time with them as I needed to. So that first year of being in business was the best year that I ever had as far as person or professional growth goes, because it allowed me to really focus on what is the true root cause of this pain that somebody's experiencing.

Speaker 2 17:19

Right.

Speaker 17:20

And from that moment on, that completely transformed everything as far as the way that I see rehab, treating the human body. And it led to this saying, where it is, it ain't.

Speaker 1 17:36

Where you're feeling it is not the problem.

Learning To Find True Root Causes

Speaker 17:39

Where the pain is, ain't where the problem is. Wherever it is, it ain't. Wherever it is, it ain't. So if you're experiencing pain in your right knee, it's because something is not going on in your right hip or even your left hip. Because we find it a lot with contralaterals. So if there's pain in the right knee, then a lot of times there's something not going right in the left hip.

Speaker 1 18:06

Right.

Speaker 18:07

And that helped me get really, really good at identifying where do we need to go to figure out what is going to give us the quickest, biggest bang for our buck to get this person back to a higher functional capacity.

Speaker 1 18:21

Treating problems and not symptoms.

Speaker 18:23

Treating problems and not symptoms. Here we are, ten years later.

Speaker 1 18:30

Ten, yes, ten years later on both sides, the physical and the nutritional inside now, which we'll get to, but that's where we all started with Burman physical therapy, the first Burman practice of treating problems and not symptoms.

Speaker 18:47

Yes. And one of the one great thing to take away from this episode is pain is not a normal part of the aging process.

Where It Is, It Ain’t

Speaker 1 18:58

Right. So many things that people say, ah, I'm just getting older, is not a normal process of aging. Age is just a number. But we start to get weaker and more painful because of the lack of mobility and strength.

Speaker 19:15

Yes. Pain, non-traumatic pain, is directly correlated with weakness. So non-traumatic, there is no trauma. The reason why the pain is happening is because something is weak somewhere else.

Speaker 1 19:30

Most likely not at the spot of the pain.

Pain Is Not Inevitable With Age

Speaker 19:32

Yeah. Where it is, it ain't. Where it is, it ain't. And to further hit home that pain is not a normal part of aging, just last week I had a 97 year old golfer purchase my online golf performance program. And I go, I meet him on Zoom to do his onboarding call. And I'm just, I cannot. Stop asking this guy questions. I mean, he still plays tennis at least twice a week. He regularly shoots his age on the golf course. And I'm talking to this guy and I'm going, You don't have any pain at all? And he goes, No, I don't have any pain at all. Like, why would I have pain? I'm going, I don't know. The rest of the world thinks that you should have pain. You're 97. He goes, Yeah, I don't really see the age. I just keep going. I'm not slowing down. I'm trying to speed up. I go, so why'd you buy my program? He goes, you know, I'm 140 yards off the T, and it'd really be nice to be 200 yards off the T again. And I'm going, Did he really just say this? At 100 or at 97 years old, he wants to gain 60 more yards off the T. Think about the mental thought process that this guy is thinking versus everybody else. He's 97 and he thinks that he can gain 60 more yards. I think he can too.

Speaker 1 21:05

Yeah. There's no reason he can't.

Speaker 21:07

There's no reason he can't. But his mental focus, his mindset is I want more. I want to do better versus all the other people. They're like, well, I made it to 90. Made it this far.

Speaker 1 21:22

Doing pretty good.

Speaker 21:23

Yeah, I'll just sit in this chair and keep going, I guess.

The 97-Year-Old Golfer Mindset

Speaker 1 21:26

Right, right. And that's where that saying, you don't get old and then stiff. You get stiff and then old.

Speaker 21:33

Exactly.

Speaker 1 21:34

Comes into play. If you keep moving and you keep strong, you're not gonna get stiff. And you're not gonna seem old. Your number, your age will say you're old, but you're not gonna seem old.

Speaker 21:45

Yeah, because you can keep moving.

Speaker 1 21:47

Correct.

Speaker 21:48

Good.

Speaker 1 21:49

I like it.

Speaker 21:51

So he who rests rots. Keep moving. Don't let the grass grow under your feet. Motion is lotion. If you don't use it, you lose it. Keep progressing because if you don't keep progressing, you start regressing.

Speaker 1 22:07

That was a lot of different sayings altogether.

Speaker 22:10

Hopefully, one of them resonates with the stuff.

Speaker 1 22:12

It ain't. You don't get old and then stiff, you get stiff and then old. Keep progressing, or else you will start regressing. Lotion is motion.

Speaker 22:23

Motion is lotion.

Speaker 1 22:25

Motion is lotion. Is that what I said? Yeah. You said lotion is motion. Motion is lotion. The see there's too many. I can't remember them all.

Speaker 22:34

And he who rests rots.

Speaker 1 22:37

Don't let the grass grow under your feet. Okay. Hopefully you got all those. Write them down.

Speaker 22:44

Good?

Speaker 1 22:45

Great.

Speaker 22:46

Good start to the new year.

Speaker 1 22:48

Absolutely.

Keep Moving: Sayings To Live By

Speaker 22:49

Love it. Keep moving. We're gonna keep rolling with this. We've got a good playlist coming up for you guys. Over the next few weeks, we're gonna talk and we'll be talking about more of the specific things that you should be focusing on to give you the best chance at really quality of life and longevity as we go through this 2026 year.

Speaker 1 23:10

Ciao for now.