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Keeping The Dream Alive With Dr. Skylar Pond

3 years ago

Many athletes find healing through chiropractic therapy, allowing them to regain their best form without going under the knife. For Dr. Skylar Pond, that same exact experience also served as his catalyst for pursuing a chiropractic career. He joins Dr. Kevin Pecca to share how attaining a serious injury shifted his passion to the medical field, opening the door to become a sports rehabilitation chiropractor and achieve a more athletic self. Dr. Skylar also tells the comprehensive story of his healing journey through this particular therapy, how he and his wife (who is skilled in chiropractic acupuncture) started a clinic, and the most mesmerizing chiropractic innovations he finds most interesting.


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Keeping The Dream Alive With Dr. Skylar Pond

In this episode, we have Dr. Skylar Pond. He is a chiropractor and a sports medicine physician at his practice in Seattle, Washington called Sports Medicine Northwest. He is the man and it was a pleasure having him share his story with me. I was fascinated with his own healing journey when he told me at the age of 23, he was told he needed to stop playing rugby and have surgery on his torn labrum in the shoulder. He had a professional rugby dream. You can imagine how devastating this was to know at such a young age but he is a determined individual who does not take no for answer.

He took it upon himself to create his own shoulder rehab program and he was able to get himself back in playing rugby which then led to competitive CrossFit events and now he is doing jiu-jitsu. He’s done a phenomenal job with rehabbing his shoulder and since he did such a good job, this naturally led to his love of chiropractic, sports medicine and getting people’s lives back. I enjoy this episode with Dr. Skylar and I know you will too. Please welcome, Dr. Skylar Pond.


We have a great guest, Dr. Skylar Pond out of Seattle, Washington. He is a sports rehabilitation chiropractor. He's doing some amazing work. He's also got a phenomenal team with them up in Seattle. The one thing I love most about him is he's got a phenomenal story on why he does what he does. Without further ado, please welcome, Dr. Skylar Pond. How are you?

I’m doing great, Dr. Pecca. This is fun. You have great energy to your intro. You're like my Bruce Buffer if I was in Octagon.

Dr. Skylar, where are you from originally?

I was born in Lahaina Maui. I haven't been back there since the third-grade. I'm looking forward to getting back there. My oldest son is graduating from high school in 2020. It’s a strange year to graduate high school but he's got his eyes on the University of Hawaii at Hilo. He's a soccer player. He'd like to get out there and play some ball. We're planning on getting out to the islands here in December 2020. Check it out and make sure it's a good place for him to pursue his education.

How did that shape you as a kid growing up out there? I've never been but I hear it's got some magical energy out there.

I like to think that there's some magic in my life and maybe it has a big deal partially to do with that. I didn't grow up as much in Lahaina. My family had a little farm property in Eastern Washington as well as in Maui and we're back and forth in my youth. I identify as Washington being home for me. That's where I spent the vast majority of my life. It was an interesting upbringing. I had some wild idealistic parents and they gave me a wild birth name with a Hawaiian language name for fun because they're being smart alecks. They gave me a name that meant heavenly full moon rising.

I've got that background of parents that are vegetarians. Before that was acceptable as even a healthy thing to do. They're 40-year vegetarians. That sets the platform of comfortable with being a little bit outside of the norm and believing in what you see to be true and being willing to swim upstream and define your identity as what's healthy for you, your worldview and working against that current because we were. We moved to the Olympic Peninsula, a logging community when I was nine years old and being a hippie, vegetarian family, that drew a lot of questions every single day. You had to be able to define yourself, your decisions and defend your worldview. That put upon me and my brothers a little chip on our shoulder and made us able to forge our own way. It's interesting that you asked that. I hadn't thought about it but I would say that indirectly, that helped set the platform for creating a life, community and clinic that we have.

You grew up playing a sport that isn't mainstream or wasn't mainstream in the US. Some of my best friends in college were rugby players, great guys, great community. They're tight-knit, all the rugby guys. Did you find that as a young kid or later in life?

Like most people, I came across it in college. I was on campus and saw a bunch of people running by in the mud. I was like, “Are you kidding me? What the heck is that?” I went to a liberal arts school in Washington. I went to Evergreen State College as my undergrad. Mostly because they let me travel abroad in my first year. I was off in Ireland, off-campus. I got exposed to rugby there and came back. It was a great community, as an alternative to a fraternity but having that community bond. It was liberating for me. The thought of being able to run at full speed into another person without wearing pads and nobody gets hurt. It's incredible.

That's what was enticing to me at first, being a young man and wanting to see if I had the mettle for it. I test myself a little bit but then everything else about the culture, community, humility and the comradery overwhelmed that. I found so much more and stuck with that for seven years before I stopped being competitive with rugby. I coach now. I've got 17 and 13-year-old boys who want to play football and smash their heads into other people. I've used rugby as a way to distract them. It's like, “I know what you're saying. You want to be physical. You want to go out there and play.”

A few years ago, I started a youth rugby program here in West Seattle with a couple of other people at the West Seattle Wildcats. I took it as a mission to teach how to properly use your body mechanics, how to engage in full contact without using your head and setting the skill of being tackled and tackling, getting down into the biomechanics. My boys, one is a senior in high school and he doesn't have access to do anything. He wants to be a collegiate soccer player but that's all shut down. They are playing high school football. I let them go out for high school football and he's tearing it up. He's having a great time. He's having the most fun. That baseline skillset of the rugby physicality set him up for safe success.

What is it like for an eighteen-year-old kid going out to Ireland for a year? College alone is liberating. I can't imagine what it was like going out to Ireland for a year. That must've been awesome.

It was surreal. It’s like taking the lid off the world and seeing what's out there. I wasn't in the Northern counties but it was a Northern part of Ireland in a fishing village called Glencolumbkille with a population of under 200 people. When you land there, you learn about the entire community. You know everybody. They're coming over for tea, they're teaching you their traditions, you're engaging, you'd make a little effort to speak a little bit of their language. For an eighteen-year-old kid, that was exciting.

I couldn't help looking around this foreign world to me and thinking, “I wonder what it would be like to raise American kids here. That might be cool. I wonder what would happen.” I gave it a shot. I started my first clinic in a little community called Douglas in the South of Ireland, way down that Southern tip where they call it the tropical part of Ireland because it sounds Southern. Douglas is even more Southern. It’s all the way down there in the most Southernmost point. The funny thing was while they call it tropical, they had rain in the tropics. It rained for 74 days continuously when we were there. It was 74 days of continuous precipitation. Not like it rained a little bit on 74 days. The entire village of Douglas flooded out from rainfall. After we left there, we got flooded out. We were like, “We gave this a shot.” It was a different community. It was a lot of fun. You are going to explaining to people what chiropractic is and having that first contact. It wasn't established there at all.

It was like turning over a fresh leaf. They didn't know much about chiropractic.

Their experience with me was, that's what chiropractic was. It was quite an experience. It made it so that, getting there, starting up and getting a license to transfer is a piece of cake. The downside being anybody who feels like being a chiropractor that day could hang up a shingle on their door and say, “I'm a chiropractor.” There was no organization and governing board. It was the Wild West. It was super exciting. My boys were 5 and 1 at that point. I was coaching their full contact rugby team for my five-year-old. It was wild. It was super fun, different culture and a different community there. It made me appreciate and miss home. The Northwest is the place to be for me and my family. This is a heck of a country to live in. I got to check that box, scratch that itch. We were there for a year and realized, “Let's get back. Let's watch the football in real-time. Let's do this right.”

Why did you decide to become a chiropractor? Was it something you always wanted to do or was it something that led you in that direction?

I had a couple of distinct experiences with my own health and with practitioners that set me on that path. My first exposure to chiropractic was when I was sixteen. I was under the impression that everybody knew the rules of the road as written in the handbook when you're sixteen. When you enter an uncontrolled intersection, you yield the right. I got into a lot of accidents when I was sixteen. I treated an uncontrolled intersection like going through a green light. I didn't even glance toward the left. I would drive through because it's like, “You know the rules.” It's like going through a green light. I don't look both ways. It's like, “You know what to do at a red light. We have an agreement here.”

I go through at 35 miles an hour looking to the right through any intersection, yielding to the right and assuming everyone else is going to do the same thing. I got T-boned three times in my first fourteen months of driving before I finally learned my lesson. I had a fantastic chiropractor there in Port Angeles where I went to high school who was generous with time, energy and skills. He took care of me in a way that I don't think my body would have recovered without this intervention. I think that it would have changed the trajectory of which I would have healed. I wouldn't have had the opportunities that I've had to continue pursuing athletic endeavors well into my adulthood. I picked up a new sport and I'm doing my best to see how far I can go with grappling and jiu-jitsu.

I don't think I'd have these opportunities if I wasn't put on the right course of healing back then when I was still developing my body. My mom tells the story still. She remembers this far better than I do but I came back from that first appointment with my chiropractor there in Port Angeles. She asked how it went. I said, “I'm going to do that when I grow up.” I said that as I walked past her and she was floored because before that I hadn’t had any interest in doing anything for money. I was going to go about and have adventures and be a kid. That was always something that was in my mind somewhere like, “Not yet, I'm busy. I'm doing this rugby thing.”

Every rugby team I played for had a lot of talented chiropractors on those teams because life in Palmer is great schools, great rugby programs and great chiropractic programs. I always had 1 or 2 talented teammates on any team I was on. For me, it was normal to be laying on the grass before a game and for a friend to come over and adjust my whole spine before I went out on the field. That was part of my experience as an athlete. I realized that's unusual for most people but in my little world, that was the way it was. It’s something I always had value in and appreciated. When I finally took the step toward it was when things became urgent for me. Like most healers, I had a profound injury that I had to overcome. It changes your mind and your purpose.

My situation was no different. I dislocated my shoulder dramatically and destabilize the joint in a rugby practice, not even a contact situation. It came out in a cone drill and hit the ground with my arm up overhead and thumping, drop the shoulder out of the socket. Not the AC joint but the glenohumeral joint. I was able to snap it back into place and that was my pattern, basically subluxated to dislocating in contact anytime a competitor was able to put a little step on me and I had to do an arm tackle. I was going to dislocate or subluxate. I had to get great with my feet.

I had to be able to get my full shoulder and head in there. That was fine and safe. Anytime someone got around me, I was vulnerable and I'd have to run the shoulder back in the socket. It kept getting worse when I was playing out on the East Coast for old blue. I was living in Manhattan at that point. I'm taking a year off from undergrad, having another adventure. It was a good time. I needed a solution. I had the jet surgeon consult and said, “I needed almost a shoulder replacement from the damage I had done to it.” The labral and the rotator cuff were both torn in a couple of different ways and places with a cyst in there. It was a disaster. It was like, “What's the outcome going to be?” He's like, “It's going to be fine. You have to stop playing rugby.” I was like, “For how long?” He’s like, “Stop playing rugby.”

I’m 21 years old and that was an outrageous thing for him to say to me. I said, “Let me give you some context. I'll stop playing rugby after this surgery if you never do surgery again then you can see what you're asking me.” That was my purpose. That's what I did. I was doing wildland firefighting and in the summers, I was playing rugby. I was going to go as far as I could with these interesting endeavors of mine. I dropped out of that pathway and engaged in whatever I could find. I went back to the chiropractic route to get the alignment of my upper thoracics and shoulder girdle in place and peripheral joints as well.

The effect of the AC joint and the neck. Everything was playing a role in that. I’m trying to get into a good position to heal from, working with some creative physical therapist and also experimenting a lot. Before CrossFit, I was doing a lot of handstand, pushups, inversions, handstand walking and doing what I could to challenge this joint in severe ways because you can't just pull on a piece of tubing and hope that then you can bring down a talented 245-pound islander. The guy that is charging at you with skill and speed, that band work isn't going to do the job. It's where I cultivated my vision of using strength as medicine to overcome injuries and accepting that my body's going to have its limitations.

I don't have to heal every little bit about it but I had to make my strength stronger than the weakness that was underlying. There's an aggressive compensation pattern to make those vulnerabilities to my biomechanics irrelevant. To make that ligamentous end range I don't have any more irrelevant because I built up enough contractile tissue around it to protect that end range and keep me from even getting there. At that point, I got excited about the success of my shoulder even though I was able to return to rugby pain-free and worry-free, the fire went on out on me a little bit and that I was way more excited about rehabbing shoulders. Looking around at my options in how to express that chiropractic was an obvious one for me with my background and my experiences. The freedom that you have as a portal of entry and being able to dictate my own treatment plans, protocols and not necessarily having things dictated to me by a surgeon that I'm associated with.

That's been the goal and the mission for the past many years in practice, since graduating has been to create the clinic that I wish I would have had access to back then when I was that person and putting together the team. My wife and I met on a crew and started a family ASAP and she was in acupuncture school. We started this clinic together. We’ve been co-treating with chiropractic acupuncture corrective exercise from day one and then we put together the appropriate team of our sports massage therapists. They are extremely talented and make our jobs much easier. Nurse practitioner that has done tens of thousands of joint reclamation projects. My worldview has always been, “Let's make the most out of what you have.”

We can accept what your labrum is and what your joint is. We don't need to use that term of wear and tear. We're not worried about that. Let's make the most out of what you have and keep you from going down the pathway to having a joint replaced someday. When I bring this nurse practitioner with her regenerative medicine expertise on board, now we can also improve what it is that you have, using her skillset with creating a regenerative atmosphere inside of a knee or a shoulder or a hip and putting a halt to a degenerative atmosphere. Adding that to the team has been a real game-changer. I had a similar situation with my rugby injury. When it came to that, my first year in jiu-jitsu, in my third tournament, I was competing in the open division. I'm up against some wild 23-year-old in the finals.

We were spazzing out because we're white belts and that's normal. You don't know what you're doing. It’s pure chaos. Anything can happen in there with a white belt and white belt crime. We ended up in some scramble and tore my medial collateral ligament and my meniscus. It had a nice pop, standing in shallow water and holding a big stone at your chest and dropping it. It’s a good release there. I was in the middle of a fight so I didn't stop but I finished it off and dealt the consequences afterward, which was not wise. I shouldn't have done that.

I was on crutches. I couldn't walk well for a while. I took as an opportunity to see what's out there and I have been hearing about Joe Rogan from Mel Gibson's dad of that time, the experience they had with regenerative medicine. I went all-in as an experiment to see what happened with me through a series of PRP in amniotic fluid and even a stem cell tissue allograft injection. I had this great situation being a team physician for that same MMA in the Brazilian jiu-jitsu team where I had two patients who as luck would have it had the exact same injury like mine. I had mine and the other competitor had her injury three months before I had mine.

The same thing though, medial collateral ligament meniscus left knee. It was great. I had this control group because I'm running their rehab and they're both about ten years younger than me. We're all doing the same rehab. The only real difference is they were both female and I was doing the regenerative protocol in addition and they were not. My healing response was I overlapped them, I overcame them quite a bit. I was back on the mat and competing when they're still trying to get the range of motion as you're squatting still. That was an eye-opener for me. It's rare to have that control group right there in your own life. I threw the switch on that. I got both of them in for simple PRP injections to get them over the hump and that did it for them. I'm still working with them but now it's on different injuries. Now we're on to hip and elbows. It’s always something.

You tore that medial meniscus and the regenerative medicine isn't going to put that back on the joint. It's going to strengthen everything around it. How does that work?

With the meniscus, you have a different vascular supply to it. Only on the outer third, you have much of a capacity to heal that meniscus. In that medial 2/3, you're not going to be able to regenerate with the deficient blood supply there. What you need out of the meniscus to make sure that the supporting structures, the articular cartilage on the top of that joint are articulating effectively with that meniscus. If you get a flap that lifts up, if you get a little bucket handle or a parrot beak or something like that, that's when you need a surgical procedure. It's important to work with that puzzle piece, make sure that these gears are lining up well together. Treating the entire health of that joint surface is important.

A major part of what you're doing when you're treating a meniscus is you can think of the meniscus in the knee joint, as the floor in a room, like this little exam room that I'm in. That meniscus would be the floor of the room and articular cartilage would be my ceiling panels in here on the top of the room. Running through there, we have ACL and PCL. We have the medial and lateral collateral ligaments. When we treat my meniscus and then there's a protocol we use for others, rather than using our diagnostic ultrasound to go right into that meniscus on the floor of the room, we will treat the entire room and fill the entire room.

It's like if we filled this whole room with red paint, the floor, my meniscus, is going to be saturated in that paint. With something like that, we were able to treat every vulnerable structure in there in a proactive way. I love the implication of ongoing durability for future ACL, PCL, MCL LCL, articular cartilage degeneration in addition to treating that meniscus itself. We also injected the medial collateral ligament directly multiple times. It's important that you treat all the supporting structures with something like this. When you lose stability in a moment like that, we can see through MRI or diagnostic ultrasound tore structures where you're overloaded but we also know that you can't have much hypermobility or end range of motion to tear some structures without affecting the integrity of your other structures.

Everything has been compromised as far as its ability to hold that pre-injury integrity like a severe ankle sprain. Even though if you don't tear the structures, you're going to have a lot of compromise to your neurologic communication area. You're going to have some structure laxity issues. You're going to have repetitive ankle rolls. You have to think about the knee in a similar way we like to treat infrapatellar, suprapatellar and all of the supporting structures. We were able to treat all of it when we go through a protocol for it. It doesn't take a significant, larger amount of time. No more expense for the patient. “It takes a couple more minutes to inject into the other relevant areas.” We treat the meniscus and everything else in there. That's what got the result for me and that's what we've had success with going forward.

After the regenerative medicine, were you feeling good without even rehabbing yet or is that something you need to incorporate to after the regenerative medicine took place?

I like that we're using this broad term, regenerative medicine because stem cell is more of a pop term than a procedure that we'd use. Within that, is in that whole world. Any biologic whether it's your own blood we're using as medicine or a tissue allograft, it all fits into that world. With regenerative medicine, like with many other things whether it's chiropractic or nutrition intervention, you're not going to have the same response as every single person. There are many factors. Some people are high dose responders and some are low responders.

Personally, I'm one of these high responders. When you take my blood, you spin it down to the platelets and growth factors and you re-inject that into one of my tissues, I have an off the charts tremendous response. It's why I have a clinic as I have now. If I didn't have that kind of response, I’m in a different direction. I was on crutches and still practicing. My clinic back then had two floors and I'm going upstairs trying to carry my crutches under one hand and using the hand-rail and hopping around on one foot. I was stuck like that not being able to weight well for several weeks. The day after my first PRP injection, I came into the clinic without my crutches.

It was the best-case scenario. I was still limping. I was still vulnerable. I was still in pain but I could weight bear and I had access to my locomotion again. I didn't stop there of course. I wanted to see what else could be done. I had a very intensive rehab protocol involving consciously manipulating my nutrition, working with intermittent fasting to get my whole system receptive in a regenerative pathway. There's been great research over the past few years that show that when you go through a fasting state, your body isn't just breaking down proteins, like eat up your bicep and now that's gone. Like with any predatorial situation that phagocytic activity is going to happen with your oldest, weakest and most vulnerable cells. Those are going to be ones that are eaten and use this protein for fuel.

Using that knowledge and going through a nutrition protocol involving some intermittent fasting. I like to be aggressive with rehab with myself. I'm always the lab rat. I'm always patient zero. I was doing unilateral squatting with the rear foot elevated. I progressed into that one so I was able to do so without catching and pain-free. That was eye-opening for me. Two things happened as a result of my knee rehab. One, I could see an in a case study compared to my other younger patients who had the same injury. I was several months ahead of them and maybe permanently ahead of them in the functionality that I got at the end of the healing process.

What I mean by that is I had a couple of objective performance factors there. One, I was 41-year-old and I was able to dunk the basketball within three months of that injury. It's on my Instagram. My child videotaped and recorded it. He goes nuts after it. He and all the kids in the neighborhood have a little party. It's mediocre. It's a Caucasian middle-aged dunk. It's not like the most exclusive thing ever seen in your life but the reaction from the children in my neighborhood is 10 out of 10. That meant a lot to me. That was only the second time I've ever done that in my life. The first time was at my tenth-year reunion when I was 28 years old in front of my old high school basketball coach on the whole basketball court.

It was like, “Take that,” kind of moment for me. Thirteen years later, I got it for the second time. That was an objective for me like I thought, “If I'm investing all this time, money, equipment and stem cell recovery would mean this to me. I have to have a stronger knee than it was before and I want to be able to dunk a ball again.” The other element from the recovery process that was objective for me was that unilateral squatting. I did a Bulgarian split squats with the barbell in both the back rack and the front rack. I was able to squat with my left leg both heavier, deeper and without any pain than my right leg with thin five months of the injury.

I realized my right knee is not so good. That's not the one that I hurt. I feel like, “This is an old man's knee. This knee feels 40 years old.” Whereas the left knee felt had this sparkly baby fresh feel to it. It was ready to go. Injecting fluid in there and separating the contact points was something that worked extremely well for me and being able to say like, “I can go 30 pounds heavier with my left knee than my right knee and it feels better.” That was a wonderful objective experience for me. That's not the same as a double-blind placebo-controlled trial but that's as good as I'm going to get with my own personal experience.

If you could go back to your original shoulder injury and walk into your own clinic, what would be the first steps on how you would take care of that injury?

It's got to be a good blend of, you've got to handle the basics well. I'd want to see a thorough assessment with an orthopedic assessment. I didn't get as much of that from my experience. I got imaging. It was like, “The image says this.” It wasn't as much about the functionality. It was all about what's going on inside that joint and what needs to be done for that. That's an important part of the story but it's only half of the story. “What we’d do and what I would have liked to see them was first, you start off with your basic ortho. We have to isolate which tissues are damaged, broken and which ones are healthy.” What are our strengths and weaknesses from an orthopedic standpoint?

The shoulder is limited when it comes to that because one tissue is broken, none of them function well and emotions end up in pain. I would like to go one step further and now let's see what the functionality is and what planes of motion are we strong and stable? How much weight in uprights and bottoms up kettlebell should we be able to press? Because with my injury, if we recall and I was still playing rugby. I was injured but I had a high-level of capacity. I wouldn't have carried me with kid gloves. I would have liked to see someone put me in challenging positions. “Let's see how you do with destabilized pressing and inverted positions.”

The kinds of things that I was experimenting with on my own, I would have loved to had someone who has context, experience and expertise running me through that and saves me all the hassle of all the trial and error and bad ideas I came up with before I finally landed on some good one. A deep understanding of strengths, weaknesses, functional goals, outcomes and what would it mean to have overcome the weaknesses would have been useful like, “You're able to a lateral raise at X weight when you get to Y weight. That's when you're clear to go onto this.” Set up a clear guideline of gauging when I've opened up access to the next level of functionality and complexity of movement.

That's the place that I went into. I wish they would have done that. When we bring it all together to the ideal that I have now, many years later, I'd like more of a holistic approach. Getting an understanding of my entire system’s health, how is my diet, nutrition, sleep, rest and recovery. How's this all playing into creating a best-case scenario? I happened to be in a position with my interests and lifestyle where I'm a high-responder. Back then when I was 21, I wouldn't think I would have been nearly as effective. I was piecemealing together a garbage vegetarian diet at that time, living on carbs like Red Vines and Snickers. I'm like, “That's vegetarian.”

Put together more of a panel. We could have done a gut-biome assessment to see how healthy my system was there. How much of my regenerative capacity is being wasted repairing a gut lining that I'm trashing? Looking into different elements and weaknesses. What's going on with the epidermis, with the skin? What can be manipulated there? That's when we delegate to naturopathic medicine. I’m trying to get like a lifestyle foundation built up. What would have been great is if I would've had someone directing the cohesive use of the things I piecemealed together having chiropractic and alignment dialed in as well as soft tissue work and acupuncture. I wish I would have had access to that regenerative medicine protocol back then. I don't think it was even an option back then.

At a minimum, using my own platelets, that age, I love the effect that you get for a platelet-rich plasma injection series for a young athlete. Oftentimes, the more involved tissue allograft approach isn't even necessary. I like to back that up now. We use class four laser and cold laser. We'll try to stimulate more out of that joint at that time. There have been some promising studies when they take a PRP. When you spin down the blood and then you isolate the platelet-rich plasma and they can laser it in isolation and they see the content of that tube change even outside of the body and like, “What role is growth factors come from?”

We backed up all of our procedures like that. Now, I don't laser the tubes. We only do that for me because I'm always a lab rat. Right after we inject your shoulder then we'd go into the shoulder with a real deep penetration like 30-joule cold laser treatments to stimulate more of a growth factor there. I'd love to see all of that for that shoulder injury early on. That's a big ask but that's what motivates my staff and me when we think about how can we improve our protocols going forward. We're always thinking about what would be that ideal situation for that acute or chronic injury? How can we manage this as best as possible?

I love what you are doing mainly for this reason because I was in a similar situation like you at twenty old but I didn't have a shoulder injury. I had a brain injury and a concussion from ice hockey. I was going to see all these brilliant doctors. It was like, “When can I play ice hockey again?” They're like, “No. You're never playing ice hockey again.” Hearing that at that age is, I started breaking down and crying because that's what I was at that age. To see medical professionals shutting down your dream almost immediately, it's incredibly frustrating.

You get crushed personally. It sounds like what you're doing is you're giving people hope, you've been there, people have hope in your story and you're getting people better. It's such a relief to hear somebody that's been through something and that patient knows it's possible to heal. That's step one. Any person that walks into your office with an injury like that, it's comforting to know that you've been there. “We got you. We are going to do our best to get you out of this,” rather than, “You're twenty years old. You're done."

I have a little bit of a come to Jesus, a little, “Let's get serious here for a second. You're an MMA fighter. You're a rugby player. You have a recurrent shoulder injury. Let's make sure this is clear. MMA is not good for your shoulder. Did you know this? We're on the same page. We both understand that if your only priority is to have a lifelong, healthy shoulder, you need a safer hobby. Are you clear about that?” “Yes, sir. I'm clear about that. That's why I'm here.” “Do you understand that it's my job to help you navigate through this otherwise vulnerable and dangerous sport as well as possible?” “Yes, sir. That’s why I'm here for.” “Let's get to work,” and we dive in. Part of my job is to educate and to make sure they understand their options. The option that we're choosing is where we know that the shoulders will be more vulnerable when we're tackling people for a living. If that’s your choice then that’s my job.

What if that same guy is like, “This is what I do. I'm doing MMA.” What's your approach then?

This is a kid who says, “Dad, I'm jumping in the pool.” I'm saying, “I'm going to teach you how to swim.” It's my job to navigate that as safely as possible. We have to build up durability. We have to understand strengths, weaknesses and build up. It's like teaching them how to swim. I don't get into the specifics of their MMA style. I'm only a few years into that journey myself and I'm not going to try to replace the advice of a coach. I'm not going to tell you when to tap or how to use a technique but they're going to have a good understanding as to what they can do to be as proactive as possible to protect themselves as much as possible. One of my first MMA patients came to me on her way to be on The Ultimate Fighter, the Dana White series.

I only had a few weeks to work with her but her problem was that when she threw a jab, it was fine. When she threw any combination, she was fine. If she missed a jab and it came up short, her shoulder would dislocate. Her coach was keeping a book by ringside and putting it underneath her arm and popping the shoulder back into the socket between rounds. it didn't happen every single time. I have to let her know, “This is dangerous. You're going to go in against people who are professionals that are great at causing permanent damage in brains, necks and spines. Going into this with a vulnerable shoulder puts you at a higher level of risk. Do you understand this?” She's like, “I'd rather be dead than not compete in the sport. I'm doing this. Are you going to help me or not?”

I'm going to help so away we go. We worked with her for a few weeks. We taped the hell out of that joint and got her into the camp. She faced an absolute ax murderer in that first round. She took a tremendous beating but her shoulder stayed in the joint. That was a bittersweet victory for team Sports Medicine Northwest but that's a decent example of what we do for people who are in that situation. We have people who are racing motorbikes as well. We talked about tremendous concussion risks, fractured pelvises and torn about shoulders. It's an absolute demolition derby when someone slips off a racing bike.

Thirty feet in the air coming down.

Even sliding out from underneath you at 170 miles an hour and going into a wall. We've seen some dramatic outcomes.

At the end of every show, I like to ask all my guests, what is one piece of advice that has resonated with you that you would like to give the audience? It could be anything.

It’s a lot easier to make your passion your work rather than get passionate about your work. If you have the opportunity to frame your life around what you love then life gets a whole lot easier. That's something that's been useful for me. I'd say that I'm a lot better at receiving advice than getting advice. My second piece of advice would be to receive advice.

Where can people find you? Where are you located, websites social media and all that stuff?

We're out here in West Seattle. The nature of the work that we do from a regenerative capacity. When we've done shows and platforms like this in the past, it's been great. We've worked with people abroad. I can zoom in and get the lifestyle dialed in for someone with their movement capacity and their nutrition. If they're doing something in our regenerative capacity, dropping in for a day from all around the country, it works. Off you go, you can have one day in the clinic and the rest is remote. We have the capacity to access anyone from any place to be useful.

I'll give you my direct contact. I've been doing this. It's been exciting is to hand out your email and see what happens but I'm happy to do. I'm going to put a cap on this. I'll get back and engage and maybe set up Zoom if someone's interested in pursuing some of the lines of communication we've been on. You can hit me on my direct email that is the website. You can see all the biographies. I have a lot of video and rehab content on the video and blog section. The Instagram channel is @Strength_As_Medicine. I'm not aggressive with my Facebook and Instagram content updating but you'll see some useful stuff up there. If you follow my personal Instagram, you get to see my adorable cats, kids and you can find that video of me dunking a ball. That's @HeavyweightSpineStraight.

Doc, thank you for coming on. You're doing some amazing work, helping out a lot of people, which it's all about. Thank you for laying out all the cards on the table, telling us about your story and I appreciate that.

I appreciate you, your audience and the opportunity. I love the energy you bring into this platform. It's a fun way to do it. It's been a good time. I appreciate it.

We'd love to have you on down the road again sometime soon.

That would be great. Any topic you want we can chop it up. That'd be fun.

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