Pain is multifactorial, and its treatment varies from case to case depending on specific circumstances. Recognizing this, Dr. Ashdin Billimoria, Lead Clinician at Strive 2 Move, emphasizes the need for an accurate assessment of patient needs and goals for the chiropractor or physical therapist to design an appropriate treatment program. Their work around functional movement is exceptionally phenomenal. Host, Dr. Kevin Pecca himself can attest to it having been a client of theirs for some time. In this conversation, they talk about Strive 2 Move’s approach in diagnosing and healing pain, the inadequacy of self-help exercise videos on YouTube, the importance of professional diagnosis, fitness program recommendations and more.
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Strive To Move, Strive To Heal With Dr. Ashdin Billimoria
We have Dr. Ashdin Billimoria. He is the Lead Clinician out of Strive 2 Move. They're an amazing chiropractic functional movement facility. They do phenomenal work. I'm a patient there. Several months ago, I was in excruciating pain almost every day leaving the office. I'm constantly bending down and I was getting adjusted. I was getting acupuncture. I would feel good for a couple of days, but there was a repetitive movement problem on my end that it was making what I do every day very difficult.
Those that have read this show know that I love what I do more than anything. It got to the point where it was becoming unenjoyable. I was grimacing at the end of the day leaving because I was constantly bending down. I needed to seek someone that could get me out of this pain and it became no longer a chiropractic issue. It was a functional movement issue. I sought out the Strive 2 Move team. On the show, we have Dr. Ashdin who was able to get me out of pain and reach new goals of what I wanted to accomplish.
I'm back in practice again and loving what I do because I'm no longer in pain and giving the best care I can to my patients because I feel good. You can't pour from an empty glass. I learned that the hard way. I can't thank Dr. Ashdin Billimoria enough. He does this with several of his clients. He's great at what he does. He's passionate about it and he's one of the best in the business. If you're having a functional movement issue, I highly recommend seeing him. We're going to get a little background about Dr. Ashdin. I hope you enjoy this episode as much as I did.
We have a very special guest, Dr. Ashdin Billimoria. He is a chiropractor, movement specialist and so much more. He is the Lead Clinician at Strive 2 Move. They do some great work there. I'm a patient there. He's helped me out tremendously. In the last couple of months, I've been leaving the office in more pain than when I started during the day. Dr. Ashdin has got me pain-free, moving again, doing the proper exercises that were tailored specifically to me to get me out of pain and to keep doing what I love. It's an honor to have him on the show. Dr. Ashdin, how are you?
I'm doing good, Kevin. Thanks for having me. I appreciate it. I know we've been going back and forth trying to figure out a day that works for us. We sometimes figure out a time and then we had to cancel, so I’m pumped to finally be on.
Thank you so much for coming on. You've helped me out tremendously. You help a ton of people out. Let's get started with where you're from and why you do what you do. Dr. Ashdin, where are you from originally?
I'm originally from Pensacola, Florida up in the Panhandle. I went to undergrad down in Tampa at the University of South Florida. I got my Chiropractic degree from Logan University in St. Louis.
Were you into sports growing up?
I played club soccer my entire life. I ran track. I've always been active and around athletes. I think it was in college, I was majoring in Athletic Training and then I decided to get out of Athletic Training and going to Health Sciences because I knew I wanted to do something else in healthcare. I didn't know exactly what, but it was probably around my junior year where I was thinking, “I want to do something.” I originally wanted to be a Physical Therapist. I wanted to go to PT school and I wanted to work with athletes.
I think I mentioned to you when you're asking me, “How did you become a chiropractor?” I started shadowing a bunch of PTs. I remember after I always left the office, I was like, “I don't know about this. I don't know if I learned a lot. I don't know if I felt like I was in the way.” That could be a byproduct of who I was shadowing and not necessarily the professional itself of physical therapy because I know a lot of good physical therapists. It might have been the people that I was shadowing.
In turn, I started shadowing some chiropractors and I started to understand what chiropractic can do for you. I saw that there was a blend between chiropractic and physical therapy or doing rehab. I was intrigued. I remember when I was looking up schools, I found this Master's program at Logan, which is what's ironically drawn me to Logan. I was going to do the Master's program in hopes of boosting my potential going to PT school. When I found out you can do it in conjunction and I like shadowing chiropractors and I was learning a lot. I was like, “I think this is the route for me.” I packed up my stuff. I moved with my then-girlfriend who's now my wife to St. Louis and the rest is history. I haven't gone back. I'm glad I decided to go to chiropractic school.
There’s a ton of different avenues you can go down once you're in chiropractic school. You found yourself in an incredible niche. It's not strictly chiropractic. What would you say is exactly what you do now?
We always talk about patient goals. I'm going to try to do what the patient needs in order to get them to their goals, whether that be strictly an adjustment, soft tissue or functional rehab. We tend to blend more on the side of functional rehab, but I don't want to lose sight of the fact of the adjustment because we do a lot of hands-on work as well. I would say probably 75%, 25% would be the rehab to the hands-on work. That's not to say the hands-on work is not important. It's just the more type of people that we see and the style of practice that we do.
What's amazing about what you do at Strive 2 Move is you didn't do any Manual Therapy on me. I was in so much pain and you did an excellent assessment of what my body needed. You gave me a ton of functional exercises and movements to get me out of pain. You put the power back into my hands to get better, which I love. How do you figure out with a patient, whether it's structural, they need an adjustment, whether it's a movement, they're doing something at work that's repetitive, that's putting them in pain? How do you assess what's going on and then carry out the treatment for each patient?
As I was saying, everyone is different. I'll give you an example of a patient that I had that came in. He's been suffering from chronic TL junction pain for the longest time. I'm palpating and he's super stiff. He's not moving well. In my head, I'm trying to teach him to move through his hips but his mid-back is super stiff. I'm exercising his dysfunction, then I had to think, “I need to put some movement into his joints. What better way than an adjustment?” I adjusted his thoracic spine TL junction, and then I paired them up into an exercise. It all depends on what the patient's coming in for and how we put them through our assessment.
What does a treatment program look like for you? How many times do you see people and what do you recommend after the first visit?
We always see every patient when it comes and there's no protocol. It depends on what the patient is looking for and what your goal is. Ideally, unless in the absence of someone being in acute pain, we see them no more than one time a week. We give them the option of 30 minutes to one-hour appointments because that allows us to be in-depth and take as a patient-centered approach to what we want to do.
What's your favorite thing to treat? I know you treat a variety of things like for instance, mine would be one of my favorite things to see is a post-concussion syndrome because that's what got me into chiropractic. What is one of your favorite things to see in the office?
I would say low back. I've been humbled by a bunch of low backs since I've started here, but I've also had some success with some. I think the everlasting change of trying to figure out a person's low back pain, whether it's functional, it's traumatic, fear avoidance or it's biopsychosocial, there are so many. Pain is multifactorial. It's interesting when a low back pain patient comes in because my head is spinning and I want to try to figure out what's going on with them.
That's what I was impressed with the assessment you did with me. You ran me through a series of tests. Explain to me your thought process on trying to figure out where are the low back pain is coming from whether it's stability, functional, or structural. How do you uncover what's going on there?
We always start with the range of motion tests. We start establishing baselines. For the readers out there, the baseline is if you can touch your toes, if you can rotate well or if you can bend backward to give you an idea. From there, based on those baselines, we're going to break it off all your hip range of motion looks. For you, if you remembered, and most patients will start with McKenzie or end range loading. It's a useful exercise to start regaining range of motion. More importantly, it starts to put the powers back in the patient's hands because they can take these exercises at home with them and do them on their own.
From there, you'll start to see if the patient's pains will start to centralize or go towards the middle of the back or if they start to respond. From there, you can tell if the patient has a directional preference, meaning if they respond to repetitive motion. There are plenty of protocols, I won't get into it. From McKenzie, we tried one way with you. I knew from that instance that you weren't going to respond to it. The biggest thing is you had an excess range of motion in your hips and you had the pain. I knew that the adjustment for you wouldn't be helpful and you would probably feel good but you would be back to where you were a few days later. Based on that, I knew we had to go more of a stability route for you.
A lot of people will go onto YouTube and they'll try to get out of low back pain. Some of the exercises are good, but as you were mentioning before, sometimes McKenzie works for some people. Other times, it's going to put you in more pain. Everybody is googling self-help exercises. How do you know when the exercise is good for you or when you should back off because it's going to be doing more harm than good?
It's not that the information on YouTube or Google is bad. It's highly educational. I think that might be the problem because it's not individualized to what's going on with you. If you would have gone and looked up on YouTube low back pain exercise and you saw McKenzie, as you saw in the office, it didn't work for you. That's the thing. It's either it could work for you, which I'll tell my patients all the time, it could and that's great. I'm glad it helped you, or it can make you worse.
It’s not that the exercise choice might be wrong and it well could be, but also how you're performing the exercise. I had a patient that it was as simple as a glute bridge like, “I saw this on Google or YouTube.” I was like, “Show me how you were doing it and then we can go past it or we can move on.” She was showing me and she was either recruiting too much of her hamstrings or overusing her pair of spinal muscles and she's still getting pain. We corrected how far she would go up or bridge up and she had no pain. She found an exercise that helped her, but she was performing it wrong. That's also detrimental.
There are many intricacies in those even like a glute bridge that you need a professional at least in the beginning. I thought I was good at that stuff. I was taught in chiropractic school and you forget. It’s the little details that you forget and I was doing a bunch of that stuff wrong in your office and like, “I'm a chiropractor. I should know how to do that.” It happens to everybody, but it's huge that you go slow and make sure you're doing the exercise right.
I always say YouTube has never meant to diagnose. It's meant there to help, but you should always get assessed by a healthcare professional if you're having symptoms at the back neck, shoulder or knees, whether it's a chiropractor or physical therapist. You should always get an assessment from a professional. You should never let YouTube diagnose you.
I'm trying to get people even around the country because I think everybody needs someone like you. Thankfully, you guys are a half-hour away from my practice where I can refer. Somebody that's reading this in St. Louis or California when they're under chiropractic care, they're getting solid adjustments but there are still some things lingering, it could be a functional movement issue. What can people look for to see someone like you? There are not a lot of people that practice like you do. I think it's important to get that functional movement aspect if somebody is trying to reach certain goals, whether it's fitness rehab, pain-free stuff. What do people look for?
There are tons of like-minded individuals and people that practice the way we do out there. It's just that you have to be able to find them. One that’s useful is the Forward Thinking Chiropractic Alliance. They have a website where they have a directory who has plenty of phenomenal doctors that I learned from and that I fall on the Facebook page. They can go on their map and they can find someone close to their area. If they’re looking for a chiropractor, they want to find someone that takes the time to listen to them and aligns the treatment with their goals, that's what it comes down to. If the adjustment is going to get you out of pain, that's great. If you're wanting to play with your kids, exercise and be completely active with your family, you're probably going to need more than that. In your head, that should automatically start light bulbs going off that, “I need more.”
Give me the rundown of people that come into your office. For people that are seeking treatment from you, who do you usually see in your office?
We see a variety of patients and conditions. What we mainly specialize in is we treat the active adult who has something that has been taken away for them, whether they're not as active with their kids, they're not pushing themselves in the gym or they're having a nagging pain at the desk. We specialize in one-on-one treatment with that patient and align again the treatment with their goals.
Another thing I notice is I see a lot of people first and foremost because it's readily available to them. I wanted to get your thoughts on personal training. People are already at the gym. I'm sure there are some extremely talented ones and I'm sure there are also ones with any profession that could probably get you in trouble. What are your thoughts on going to the gym and seeking a personal trainer?
There’s good and bad in every profession. We have an office in a gym with Gabriele Fitness & Performance In New Jersey. We work hand-in-hand with a lot of the trainers because a lot of the patients that we see from this gym are super active. They don't want to leave the gym. We communicate with the trainers on what patient A needs to stay away from and what they can modify and then the trainers tailored to them.
I think it's an awesome relationship and it helps us in the treatment room because we have that communication. I think anyone seeking the personal trainer, it's fine. There’s good and bad in every profession. You want to make sure that trainer is aligning what they're training you with what you want to do. That's what it comes down to. What do you want to accomplish in the gym? If that trainer aligns it with what you are wanting to accomplish, you have a good trainer.
What are your thoughts on CrossFit? I know you've started doing it over. When people hear the word CrossFit, they shut it down. They're like, “No. Awful. Bad exercises for people.” It's simply not the case. How do you feel about CrossFit? What do you like about it?
I am extremely new to CrossFit, performing wise, we treat a lot of CrossFitters in the office. As far as the movements, I am new to CrossFit, but I'm loving it. I think from what I hear, it used to get a bad rep because they would toss people into the gyms without coaching them. From what I've seen from the gyms that we are affiliated with, the gym that I go to CrossFit stuff, that's not the case. The coaches there take time to teach you the movement and every workout, every exercise can be modified and scaled down to that individual's needs. I 100% think CrossFit is perfectly fine as an exercise or a gym and I love it. It's all modifiable and scalable down to what you can do. The coaches take time to teach you, which is the most important part. I recommend CrossFit to patients who are looking to change up their gym routine 100%.
That's been making you feel good too, the actual exercises?
Yes. I remember I was getting bored with working out in the gym. I didn't have a good routine. I wasn't seeing the results that I wanted to see. I wasn't pushing myself. I was doing it to do it, which is not what I was wanting to do anymore. My wife and I always talked about joining CrossFit. We found a CrossFit gym a couple of minutes from our apartment. We've been going for a little over a month-and-a-half and we love it. We get our asses kicked, but it's great.
You said something interesting there that you can well do a lot of those movements by yourself, but it was almost like a motivational aspect where they put enthusiasm back in the workout for you.
I'm also hoping to learn something from the coaches too. We see a ton of CrossFitters and I know what the movements entail and how they work, but that doesn't mean that I can physically get my body into those positions. That's where I love the coaching that comes with it. If I can hear a cue that works for me, that's a brand-new cue for me, but maybe I can in turn use it on the patient. I'm trying to break down this movement for them in the office.
Let's say a snatch. I'm working on a cross with snatching. I know what entails in that movement, it doesn't mean I can get my body into that position. With the right coaching that I'm getting at the gym and I'm hearing these different cues, I love it. I can do it now, which is great. The learning aspect, which I'm going in which is awesome, I'm picking up on all these different cues and exercise positions that I know that I can in turn help my patients.
This is something we’re going to talk about on my next visit. I’m at the point where I want my low back to be. When you get patients where the goal has been reached, and they can still want to continue to work with you, what do you recommend? If someone came in for low back pain, it's gone, but they love what you do so much. What do you do next with that patient?
I ask them what they want to do. It’s like, “You tell me what you want to do. It's your decision.” We have many different plans where some patients come every other week, they begin to taper off. They come once a month. We have some patients where we'll write exercise programs for them and then they'll check back in with us in a month. It's what they want to do because what they tell me is, they give me the recommendation and then that helps me best follow up with them. We have a mix of people coming every two weeks for a little bit, once a month or we strictly taper off and we write exercise programs for them. It depends on what that patient is looking for. Some patients will continue to see us once a week if they feel they haven't met their goals yet but I know your question was if they have reached it and that's what happens.
With you, I've reached getting out of low back pain. I think we're scraping the surface. I want to continue. I want to make it focused on the entire body now. If somebody has a specific area, maybe it's not like an activity you do, would you be able to give me a tailored exercise for surfing and balance and all that? How would you go about that? If it's an activity you know about, how do you move from there?
We're at the stage for you where we've got you nice and strong. We've got you feeling what you need to feel, but we have to put you back in what I call performance. We have to translate what we've done in the gym into real life and functional. We're getting to that point where we can start to translate what we've done in the treatment room into your hobbies like surfing, balancing and functional.
It's crazy how powerful the mind is because in my mind, I went to go play hockey and I'm like, “I'm still the man.” My brain is like, “You still got this.” I got out there and I'm like, “I don't got this.” You don't do something for a while and your brain thinks you're good, but your body is like, “I'm not an athlete anymore. I haven't played a full 60-minute game in years.” There's muscle memory but it forgets. Many of my muscles weren't working the way they once were and my brain's like, “You're an athlete. You'll always be an athlete.” What I'm uncovering now is that there are muscles I haven't used in so long and it's become a problem.
You see that and you don't even realize it until you get back into doing what you haven't done in a long time and then to realize like, “I still have a long way to go.” The exciting thing is that you're out there, you're playing. You felt good. You didn't get hurt, which is huge.
How long does it take to maybe retrain muscles that have taken 3, 4, 5 years off? What does that process look like?
I wish I had the answer to that. Whenever a patient will ask me how long, I'll be honest with them. I truly don't know from a timetable, but what I'm confident in is answering based on what we found in their assessment, their movements flaws, or dysfunctions, or what we talked about their concerns and goals. I'm more confident in addressing those issues than giving them a timetable because I know if we address those issues, it's going to speed up time. It will go by. It’s like, “We'll be fine. We'll progress then.” As far as a 9-week, 10-week, 11-week, something like that, I truly don't know.
It also depends on the work your patients are putting into the exercises you give them.
That's always like patient-dependent, but we found that the people that come to see us, they're highly motivated to want to get better. They want to do their exercises. We have that conversation on day one with patients because we try to get an understanding of how is their plan of care going to look? Is this patient going to be highly dependent upon us? Do we have to push them a little bit more to do their exercises? Which is fine, as long as we know and we understand, and then they understand what we expect, then we're going to progress well. We have patients that they want to do the exercise. They want to take them home and get better. Working with those types of patients is a blessing.
Dr. Ashdin, where can people find you online, the practice and if people want to make a new appointment with you?
It’s Strive2Move.com. You can call the front desk, Lauren, who handles all patient services. We'll be happy to take your call and schedule an appointment. We're on Instagram, @Strive2Move, or I'll also have my own Instagram, @Movement.By.Ash. That's my personal movement health page. People can find me there.
Where is your practice located?
We have an office in Warren, New Jersey, and as well as Berkeley Heights. Our Berkeley Heights office is located in Gabriele Fitness & Performance, which is an active adult gym or small set of classes.
At the end of every show, I like to ask all my guests, what is one piece of advice that has resonated with you over the years that you would like to gift the audience? It could be anything.
Within the past year, I discovered the mindset, like a training mindset between growth and a fixed mindset. For me, that's been huge like uncovering a growth mindset and learning that you can change. You are adaptable. Just because you mess up at one thing doesn't mean you suck. It doesn't mean you're worthless or anything of that nature. Having a growth mindset means you don't have to essentially validate yourself to people. It does allow you to think and not react. We’ll tell anyone to start learning about mindset, because it's been extremely beneficial to me early on in my career. I wish I would have found it early, but I'm glad I found that at the beginning of my career.
Dr. Ashdin, thank you so much for coming on. I would love to have you back on any time. I'm excited to keep working with you and getting back to where my body needs to be.
Kevin, it's been a pleasure working with you. Thanks for having me on. I'd love to come back. I appreciate it.
- Strive 2 Move
- Forward Thinking Chiropractic Alliance
- Gabriele Fitness & Performance
- @Strive2Move - Instagram
- @Movement.By.Ash - Instagram
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