Sara's PHT Success Story

On today's episode we have Sarah's PhD Success Story. Welcome to the podcast that gives you the most up-to-date evidence-based information on PhD rehab. My name is Brody, I am an online physio, but I've also managed to overcome my own battle with PhD in the past, and now I've made my mission to give you all the resources you need to overcome this condition yourself. So with that, let's dive into today's episode. Sarah has a great success story that takes a lot of different avenues, so I'm excited to share this with you. I know a lot of you are drawn to and enjoy these success stories, and so you'll learn a lot about Sarah. She has had PhD for several years, it's like seven or eight years if we include like all the ups and downs of this journey. And before I get into the interview, she did mention that her email is available if you do want to reach out and say hi, she said it at the very end, so I thought I'd mention it here just in case you tune out or move on to something else before we bring this interview to a close, but I will keep her email in the show notes. And let's get on and share her success. Here is Sarah. Sarah, thank you very much for joining me on the podcast. Thank you for having me, Brody. I know it was a while ago since the initial onset of symptoms, but if you can cast your mind back and maybe as accurately as you can try, what were the initials? The initial onset of symptoms lack and took us through that time. Sure. When I think about how long ago I remember feeling PhD symptoms, it was, I mean, it was as far back as 2009, which is a really long time ago. I remember having that, that ache from running, I've been a runner since college, just recreational runner. And remember that pain in the right there in the attachment there in the buttocks and what is this? And but it kind of would go away with time off and I did remember doing some acupuncture and things like that. And then I think I remember it plaguing me again in 2012 when I was marathon training, but I remember it going away and not being much more of an issue. So it really wasn't until 2017 when I feel like it came back again and became chronic. So pretty much from 2017 until, you know, till now or until 2024. So I like to think I'm mostly healed now. It was just I couldn't beat it. I couldn't beat it and anything I tried, you know, was not lasting. Was there anything around about that time in 2017 that caused that resurgence that you can think of? Well, not, I was, you know, the last marathon I did was in 2013. So I was, you know, not doing the kind of mileage I was doing in my, you know, 30s, 20s and 30s. And so no, nothing like, you know, I had an increased mileage. I wasn't marathon training. I was just doing like my couple half marathon's a year, two or three a year that I enjoyed doing my 10 mile run on the weekends that I really enjoyed doing. That was kind of my routine. And I just remember it setting in and running through it for a time short too long thinking that, you know, it was just nothing. It was just going to go away, but it got worse and worse. So no, nothing like physically changed during that time. You know, in my life, I realized now looking back at it, you know, it was a big year of transition for me. And as I, as I probably will get into a little bit of the, my bodywork I've been doing in the last six months, the big change in 2017 was, was I retired from the military after 20 years. And so I stepped away from that career and was starting a new one. So I was luck going on that year, you know, when I looked back at it, which, you know, I'm not saying that was that caused my symptoms, but it was just I brought, you know, when I think back to what a big life changed that was, I found that to be interesting. Gotcha. And I guess it'd be reasonable to think that if you've had a couple of bouts of this PhD in the past and it's gone away, that this one would go away too, but seems to be more stubborn and more persistent. Right. And that's when I finally, after I think it was at least a good six months before I really started, you know, which a doctor like, well, maybe I should go see a sports doctor about this. And that's when I started the journey of trying to get help and many passive treatments, which let me down a huge spiral for years and years. Talk us through that. So like you would have had, okay, initial onset of symptoms, well for this bout anyway, six months of kind of ignoring it, but try to run through it. And then, and then realize how could run anymore. It just hurt too bad. I was like it hurt too bad. I have to stop running finally gave up. And that's when I made the appointment with the doctor who, since I, you know, communicated that I've been going on this long, he kind of went ahead and ordered an MRI, but also did offered me right off the right of the bat offered me treatments, which I was like glad to take offered me something called pro therapy things I've never heard of pro therapy and PRP. I was still in the, yeah, that was right before it was, I was exiting the military that time, but it actually still, still eligible for benefits through the military. So I was getting PRP treatments for free, which, you know, those are very expensive treatments, which I probably never would have gotten otherwise, but because I was retired military, I was able to get them. And so I had several of those over the course of a year, I think like four in both buttocks. You know why I kept getting them? I don't know because I guess he just convinced me that well, it maybe you just need it again. They didn't, they didn't help. They didn't help. You did not see any improvement, even in the short term? Maiden, like not, not, not, not much. I mean, maybe just maybe a little, maybe short term, it was, if anything, it was very short term, which is why I kept going back and he'd say, well, we can do this again. And so I just felt like that's the only thing that you can do. And then physical therapy. And then of course, he recommended physical therapy, which I did and I was doing probably half ass honestly. Like not really, because not really finding what they were telling me to do that helpful, plus with my full time work schedule, it was so impossible to go regularly. And so I didn't find that any of that really helped. So I was more seeking out the passive treatments, which led to let's try acupuncture. Let's try, you know, dry kneeling. I don't even want to say how many dry kneeling sessions I have had and paid for none of which really helped over those many years. Was a diagnosis like straight away? Was it accurate? Yes, straight away. Yeah, diagnosis. Yeah, he told me right away. He said it was hamstrings. I'm like hamstrings, you know, that kind of, like I didn't realize that was part of your hamstring, but I was, that's when I started learning about hamstring, tendonopathy. He did, you know, it was diagnosis hamstring, bilateral, proximal hamstring, tendonopathy, or tendonitis, whatever he called it. And so that was kind of the diagnosis that I've just kind of just accepted that I had and was going to try and beat, but just couldn't, you know, couldn't really beat it, couldn't beat it. Fast forward to 2022, still dealing with it, you know, I might have had short periods of like recovery where I would try to run, but never was able to run the distance that I wanted to and was not running pain-free, really, not for any like the appreciable time during that. And then in about, yeah, I guess it was 2022, it actually then the pain moved to like the outer part of the buttocks. The pain would move in the buttocks and it came on the right side, it became really bad. And I think that then I was diagnosed, had more MRIs. That time it was diagnosed as, which was a different doctor at this point. I kind of gave up on the doctor and the practice I was seeing through the military. So I went out in town and saw a different doctor who said it was gluteal tenonopathy. And that was actually worse than the PhD. I still had the PhD, but I had this new onset of gluteal tenonopathy on more of the outer side of the right hip in particular that was just, it was awful. It was just, it was awful. And that led me to, you know, still doing dry kneeling and nothing helping. That led me to a procedure called tenx, which I had in 2022, which provided me short-term relief for maybe three to four months. I actually the pain went away. I was like, oh, it went away. I can start running again. Started running again. 2022, end of 2022. It pain-free for a short while, but then boom, it just set back in. Maybe after three to four months. I'm like, oh no, it's back. Maybe I did too much. I increased my mileage too much. I was beating myself up and went back to physical therapy and got more dry kneeling and more tenautomies. He offered the sports medicine doctor, was offering me these percutaneous tenautomies, which I said, sure, shoot me up. Anything to get rid of the pain in the buttocks, just anything. And then, so that kind of got me to, late 2023 is when I was getting more tenautomies and nothing. It was worse. They didn't help at all. So I was at my wit's end. And then, the symptoms changed over that fall and winter to where now it didn't just hurt to run. It didn't just hurt to walk up the stairs, but sitting started to plague me. Sitting wasn't always a problem. But it was off and on. But never to the intensity of late 2023 and spring of 2024, where I just, I could not sit. Driving was miserable and I only had a 15-minute commute to work. Driving hurt, sitting hurt. I was always constantly aware of the pain, like always. And that's when I really started to, I don't know, get to the lowest of my low with his injury. Like I started it. I was depressed. Not depressed in life, but depressed about this pain. Because I'm a very happy fulfilling life with my work and my family and my children. But I was always thinking about the pain, like always. Think it and then started to think. think that it was never going to go away, that I would have pain sitting and pain in my butt the rest of my life. That was just, I didn't want to accept it, but I didn't know any other, I don't know, I just was starting to think that this is my life, I'm going to have butt pain the rest of my life, because all these passive treatments I've tried, none of it has provided relief. And that was when I started just again constantly searching on the internet for solutions, learning that maybe it was all in strength training that I wasn't doing enough of. So I started to look into that and that's when I found you. That's when I found your website and I thought, oh my goodness, there's a physical therapist who specializes in Ph.T. Who's this guy? You know, and I started reading your review, you know, reading about you and listening to your podcast before I even reached out to you and was finding some glimmers of hope because I was, I think I'd listen to some success stories of people who had healed and improved through your program. And then I, then that was when I saw you had offered a free injury chat and that got started our relationship. Through the information and, I guess, knowledge that you built, I guess, finding the podcast and us starting to work together, was there any major differences or gaps in your rehab or things that we might have tried that you hadn't set up yet? Since I, you know, once I met you or that, because I guess from, from 2017 when this all started and all those symptoms started to build up and build up and you said you've mentioned try and edeling, you've mentioned like shockwave, you've mentioned all that sort of stuff. Was there any missing pieces after you've gone to the podcast and start listening to Ph.T. treatment? Were you like, oh, I haven't tried that yet. Oh, yes, I was starting to realize in listening to your things that the answers were the one of the biggest mistakes that chronic sufferers make is relying on those passive treatments and not on the strength training. And I thought, yes, I've done physical therapy, but I've never done physical therapy like what you offered me and what you, the program you created for me never did anything that persistent or the load, the increase in loading. And then I started to read about the increase in loading and how important that was and I thought, oh, my gosh, that's maybe what I'm missing. Is it all really in the exercise? I'm doing all these other past, you know, I just really started to realize that exercise was what I needed and I needed somebody to guide me through what exercises to do and how to to load the tendon. And that's yeah, and that's what you, that's what you offered me and that's what I started doing religiously. Yeah, because I do get people jumping on injury chats and people messaging me, email me, saying, I've tried everything and P.T. is in there. I've tried shockwave, I've tried injections, I've tried P.T. and that sort of stuff. Right. And that's when I like to dive into, well, what does your P.T. look like? What exercises? How consistent are you with them? Yes. You know, and so I guess sort of very in between the lines here, but your P.T. may have been a little bit more inconsistent and incredibly inconsistent. I mean, it's hard to stick with with a program. If you don't have somebody really prescribing what to do and if you're, I aren't able to go in person, like, was what the only P.T. I do is, you know, in person, they give you a paper of exercises to do, but it's, it was hard to, because I didn't think they worked. I didn't think that that was the answer. I thought the answer had to be in shots and had to be in injections. Now it makes no sense to me, but I thought that, but at the time, I just, I thought that was the solution. And kept looking for, you know, more treatments. And I think when I met you, I was all intrigued about this shockwave therapy I'd never really heard of and there was some promise there and I almost did that. I didn't, because you advised me to try the P.T. program first, which I'm glad I did, because I didn't end up needing the shockwave treatment. Yeah. Like usually when someone says, let's try, what about what do you think about this? What do you think about this? And it might be injection surgery, shockwave stretches. My usual advice is, look, if you haven't given the slow, heavy, progressive strength training ago, just give that a go first because that's gold standard. That's initial foundation principles. Let's get the principles and the foundations in place first. Do that for several months and see what the effects are like. And then we can have a conversation of whether we layer in shockwave or whether we're layer in some stretches or something else that might be had. And so I guess my advice at that time would have been, hey, just give this a go first because in a scenario you could be getting better and we don't need to do all those things. I need to spend money on dry handling and that sort of stuff. From memory, how effective do you think that approach was? It was good. I mean, I started doing the exercise routine three days a week and the cardio, you know, just the program that you designed for me and it was very doable and, you know, it was just manageable and I loved the structure of it. And I started to notice, I think pretty not like immediately, but over the course of the first month, for, I'll say over the course of the first three to six weeks, I noticed a reduction in the sitting pain. The pain did not, you definitely didn't go away overnight by any means, but I just noticed it was a little bit more manageable. It wasn't as bad sitting or getting out of the car. I mean, I was getting out of the car and I felt like an, you know, 70 year old woman, just because of the pain of just standing from sitting was the worst. And I was able to do that with a little bit less pain. So I started to get hope back and I found that it wasn't, you know, crying all the time. I wasn't crying myself to sleep over this, you know, like I had been. So it was literally, literally crying itself to sleep. Sometimes, sometimes, not because of pain, not because I didn't have any pain when I was laying in bed. I was just sad that I couldn't run anymore. I was sad that I had always thinking about but pain. And, you know, I'd, yeah, I was, I mean, for those couple months, you know, I wasn't not for years crying myself to sleep, but just for that, when I got to that bad worst, I could not sit without pain at work. I couldn't sit at work. I couldn't sit driving. I just thought, this is no, no, this is horrible. It was really horrible. And I mean, I love, I don't take for granted now that I, I mean, I sit now without pain. It's amazing. And I don't take it for granted. Now, it's not 100%. I'm not 100%. But, you know, if I sit a long time in the car, I'll start to feel a little ache in the one side only, but it's nothing like it was. And it's manageable. So, yeah. So anyway, yeah, I started to notice some improvement. I think we started working together. I remember I was right around Cinco de Mayo. I was right around May 5th of last year. And May, June, July, you have me running. You said you can start running. And I was like a maze that you wanted me to try running because I hadn't been because I was too fearful of running and just didn't enjoy it because it hurt. And so you had me slowly, slowly start jogging again, which was that too gave me, you know, improved my mood and my mental, you know, just improved my well-being to just be out on the road again, even though I was slow and it still hurt. At least I was doing it. You convinced me that I wasn't doing further damage by being out there, you know, jogging. And so that was that was nice. What was your, I guess, mindset towards, I guess when you introduce running for and it's been such a long period of time, some people can have the, oh my god, I'm out here, this feels amazing, feels good to get moving, feels good to at least see a road map to back to the goals that I want. Yes. But some people can also have a lot of fear. They can be running and very hyper vigilant, thinking about their hamstring every step of the way, thinking or believing that it might make things worse and increase the tear or something like that. Were you any of those caps? Yes, I was still very anxious about running. I wasn't, yeah, I definitely wasn't like, you know, in law, law, and running, thinking this is great because again, I still had the pain and so there was still the will it ever really go away, you know, is it better? Is it not better? How bad is it her? What's the number of pain? Am I a two? Am I a three? Am I a four? Like still constantly thinking about the hamstrings, both of them at this point, you know, still. And once I worse than the other, but both of them. And so yeah, just still wondering, still doubtful that this was going to work, but yet had a lot of hope. And it was starting to get better. And then I'll go ahead and I guess, fast forward to August, you know, I think you'll recall that I was really wanting to run this an apolis 10 mile run that I've run every single year, even with the except for the COVID years, they didn't have it. But every other year I've run it even in pain. I would do it because it just, I don't know, because I loved it. And I wasn't going to let it stop me. So I ran a couple years very, you know, very unenjoyable walking, you know, walking jogging because of the pain. But I was going to do that this year. And so I was signed up and it was getting closer and I was getting nervous because I wasn't sure I was ready. And but my otherwise wise, I was ready endurance wise, I was ready. But then when the race day came and it wasn't really good. And, you know, probably because I was out there, you know, at a quicker pace than when I was training, you know, because you do that in races and it hurt. And I was aware of it the whole time, thought about it the whole time, walked, you know, I wasn't running the whole thing. I would walk, run, walk, run, five minute, run, one minute walk or whatever was you advised me to do. I did. But I just, I'm, you know, tearful during most of it because I just, I want to run the whole time. And I just was thinking, shoot, maybe this isn't really all the way working for me. What's what am I missing here? And that was August, mid-August of 2024. And we, I was still meeting with you monthly, I believe at that point, Brody. And that was when you kind of advised me to, had I looked into this book, think away your pain by David Shrechter, if I have an incorrect. And, you know, I'm always open to learning these things and books, if you know, reading books, if I can find the time and you convinced me to just, or you suggested that I read it. And so I bought it and started reading it and immediately reading this book, there's, there's just like, a lot of things just really resonated with me. I felt like I was reading about myself and, and I started to really be intrigued by what they were suggesting with chronic pain. So that let me down with a different path, or not a different path, but just apath and to looking into the association between all the mental energy I was expending on thinking about my hamstring pain and how that didn't help my hamstring pain. Ask like prior to this, think away your pain book. How much of an improvement, like percentage wise, this roundabouts, do you think that the conventional P-HT treatment of load management and slow, heavy progressive strength training? How much did you think you improved before this suggestion of. Yeah, that's a great question. I feel like I remember sitting not being so bad for sure. I could say at least 50% better, 60% better, maybe? 60% better. Yeah, 60% better. You're back to racing. You sort of did that 10 mile race. Yes. Yeah, I could do it. I just couldn't do it pain-free. My goal was pain-free. I'm 50 years old. I don't expect zero pain. I expect aches and pains, but this was still what I felt, tendonopathy pain, not normal pain, that you could run as marathon on or something like that if that was your goal. I definitely was better. It definitely was better and mentally better. It was just that race got me down because I'm like, "Darren, I can't race pain-free yet. I've been doing this program for three months now." May, June, July, August. Yeah, I was hoping that I would be pain-free then, but you had told me in the beginning, six to 12 months, I think, to expect, but I was thinking that I was going to beat that and be better by three months. So, I had to go. Recovery from P-H-T has never been simpler. If you've been struggling with this condition and you're not sure what to do next, I've put together something to help. Being in the show notes is a 30-second question, literally just six multiple choice questions, and based on your answers, I'll point you towards the most effective next step for your situation. Because over the years, I've created a range of resources from free education to structured, self-guided programs all the way up to working with me directly, all of which are aimed to strip away the mountain of misinformation about recovering from this diagnosis and taking out all the guesswork that leaves people like you overwhelmed. If that sounds helpful, don't wait until the end of this episode. Click on the link in the show notes now and I'll guide you from there. Keep resetting my expectations and reminding myself how much better I was than I was in May when I was at my lowest of low-with-a-pain. Yeah. Yeah. And so, you mentioned you opened up this book, think about your pain, and immediately there was a lot of things that were resonating with you. Can you recall what sort of things? This recall just. I mean, I even bought the workbook and so the workbook had you journaling and I was religiously for the next 30 days. It was a 30 day kind of journaling program. We'd get up first thing I would do in the morning with my cup of coffee was the spend five. It took me three to four to five minutes to journal about what it recommended you journal about. So, I did that because it was kind of suggested to try that and I found that very cathartic and helpful. Can you recall what that process was? What were you journaling about? Well, it gave you prompts. It gave you prompts. Okay. Even asking questions about your childhood, asking questions about when your pain started and what. that was when I started to draw associations with when my chronic pain started. It wasn't just that I left a military career but it was the same year that my daughter was finishing up her. my 11 year old daughter was finishing up her cancer treatment and there was a lot of stress going on in our lives right then and like, so there's bound to be some connection there. And so, I just started to really think about believing that you can think about your pain differently, not be so negative and maybe that there is a mind-body connection and for some reason my mind wasn't letting the pain go because it was serving some kind of purpose. I didn't know what at the time and I still don't know what at the time. It has served because it definitely didn't feel like it made my life any more pleasant but it was a distraction, I guess. But just learning about the connection of chronic pain and how the mind thinking about it all the time and thinking negatively about it all the time is not going to help. So I really tried to. I went out for a run and tried to tell my jogger and try to tell myself the pain is. I told my pain to go away as I was running. I was actually screaming it in my mind. Like, go away, stop, go away. It's crazy and I've no sounds totally ludicrous but I felt like the pain was better on that jog. I'm like, well that's something. And then I just. that was when I met with you and you told me, if you think there's any help in that book, keep putting your energy into reading about or whatever you need to do with that, learning about TMS. TMS is tension, my own neural syndrome. I think it's the name that they've given this kind of. I don't know what to call disorder but it's syndrome. And so I read a second book. The second book resonated with me just as much and then I read a third book. And so I don't think these books cured me but they really opened my eyes to another explanation for the pain and how to deal with it and kind of meditate about it and listening to some podcasts about it and I don't know, my symptoms continue to improve. They continue to improve. I actually stopped doing the physical therapy workouts which was really hard for me to let go of doing but I stopped just to see if. because I thought maybe I was thinking about that as being the source of my healing too much and so I stopped and the pain didn't get any worse. So I just kept going with it. So I kept going with it and now it's, you know, 2025 and I'm running mostly. I get twinges and I have something going on in the piriformis right now. I don't think it's really Ph.T. it's in a different area. It keeps moving around in the buttocks and so it alarms me but I'm trying to just like, again, not make a big deal about it. Not taking some time off and recognizing that I'm under a lot of stress right now and maybe that's why I'm having something. So yeah, I think that's what I've learned is that there's a connection between stress and your pain. And the biggest thing I learned though is my pain is, it's not that my pain wasn't real. My pain was absolutely real. It was absolutely real but I just spent too much time thinking about it and that didn't help. Do you think there's any particular personality traits? Maybe some that you possess that might have increased the likelihood of something developing into TMS? I mean, the books, the books I read all allude to that there's a certain personality trait that makes you more prone to TMS being the cause of your chronic pain and why the pain goes on so long. And it's kind of the type A, you know, perfectionistic, you know, personality which I've always possessed, judgmental of myself, you know, never, I'm never, you know, quite doing enough even though I don't know how much more I could do in my days. I always, always feeling like I could do more all the shit I would I could as a lot of that. A lot of kind of feeding oneself up. Sometimes if I didn't do something, what I thought was perfect or expected of me and a super people pleaser to a fault, like just caring too much about what other people think about me. Colleagues, family members, friends, just caring too much. I think all that kind of plays that's some of the characteristics I know they describe in my readings about making you more prone to TMS. Carrying a lot of responsibility as well, would you say that? Yes. Yes. I mean, a full-time job of husband and six children is a lot of responsibility. And I love it. I love my life. But it's a lot. It's a lot. And so, yeah. So somehow this pain was serving some purpose and I just had to let it go. I had to convince myself to let it go. And to believe that there's really nothing, this is what the hardest part is still believe. And I still started believe it. But they, you know, supposed to believe that there's really nothing wrong with me. Like that there's not, yes, the MRI show tendinopathy. But a lot of people can show tendinopathy as you've explained to me and not have pain. So believing that the imaging is not the cause of my pain is not that there's really nothing wrong with me because no injury should last seven years. Unless it's a torn tendon that needs surgery. And they always told me every doctor I went to and I even went to a hip surgeon right before I met you. I don't think I've ever shared that with you because I was embarrassed to tell you that I went to a surgeon after not really doing good PT first. But I already had the appointment and I went and he kind of looked at my images and was like, yeah, you're fine. You don't need surgery. And I knew he was going to say that. But I needed to hear, I needed to hear it because the pain was so bad at that time. I needed somebody to tell me that I wasn't fully broken and I didn't need some big major surgery. So once he told me that is when I really dove into your PT. But like yes, you can try to believe that there's nothing physically wrong and that yes, there is a tendinopathy there. But I like to think of it as the somewhere along your rehab pain journey that has manifested a little bit of like mind body, a little bit of it is responsible for the emotions, the thoughts, the feelings. And then somewhere along the line, that just became more and more prominent and looking back at your history. and it was 2012, started developing these pH T-Lock symptoms as a result of maybe training for a marathon or something, which would make complete sense. And then it went away, which makes sense. The body heals. They happened again. Then somewhere along the line of this last bout that was hard to budge, it was getting more persistent, getting more chronic. And I like to think, okay, well, this would still fit a pattern of a tendonopathy. Maybe that is most of the pain presentation. But then just me picking up a lot of things that you've described today, you've mentioned, okay, when the pain returned, I was beating myself up. I did too much running on damn. I'm blaming myself. Then it kind of spirals into, okay, it's becoming all consuming. It's like I'm thinking about it all the time. Like I am sometimes at the worst of it crying myself to sleep. I am really dreading the future. I am thinking this is never going to go away. And like somewhere along the line, this has just become more and more emotional as become more and more, I know, systemic within your body. And it's, it goes to makes perfect sense to me why it would start off like a tendonopathy. And your complete belief would be, yep, it's a tendonopathy, it behaves like a tendonopathy. But just somewhere along the line, just this slow evolution of your pain history and the pain story gets to the point at the end where it's like this makes no mechanical sense. A lot of this is just wrapped up in emotions and what I'm telling myself and the thoughts and the feelings and that's really hard to budge. But then we have to kind of shift our belief to be like, okay, right now where we sit, where we find ourselves, a lot of this is to do with how you're thinking your emotions. And then I say it starts behaving like a TMS type of presentation. You tell yourself, go away pain and it feels a bit better. Although you might go for a run where you think about your hamstring the entire time. And it's a little bit worse even though the running was the same distance, the same speed, exactly the same mechanical load. Things start to shift and then you open up this book, think away your pain, you start journaling, you start implementing some of these strategies and things start feeling a little bit better. As an experiment, you take away the strength training and things aren't getting worse, things are heading in that right direction. So that's where I, as a therapist, kind of suggested the book to you because it seemed like at some point along the line it wasn't making mechanical sense and let's start exploring these other ideas. And you mentioned it started getting a bit better. I would be curious if you can recall when you started doing the journaling and that sort of stuff, did you notice a shift or an improvement or a reduction in your symptoms straight away or did that take time? I mean, I think I noticed some reduction definitely from this, over that 30 day period of journaling, I do think I noticed an reduction because I was reading every day, that was reading one of those two books every day and just, yeah, just like, I was getting more hope, I was getting more belief, I was talking to you suggested I talked to someone else that you knew who had done some of this work and talking with her helped me and she was the one that advised me to give PT a break and I'm like, oh, I don't know if I can do that, but I took a leap and did and, but yeah, I definitely feel like, and that's why I kept reading because over that journaling period, which I enjoyed and, you know, felt like I learned just a lot about myself in doing and I recommend that if anybody's going to read the book, I'd recommend the journal that goes along with it. And I'm not a journal, I mean, I was a journal when I was young, but I don't journal now regularly at all the time. But I made the time, I made that commitment for that month and I noticed an improvement, which is why I know I continue to read and listen to some podcasts and things about TMS. I'm feeling helpful and I'm re-listening to them now that I'm having this little flare of whatever is going on and it hasn't stopped me from running and I'm sitting okay and all that, but, you know, I'm not freaking out that I have some pain when I'm jogging this week. You know, I'm trying to connect it and just, you know, again, not overanalyze it, try not overanalyze it. Yeah, that was another thing that I heard you talk about that I thought might have been a trait to TMS. It's like you mentioned during the PhD, you're constantly instant searching for answers and constantly. Kind of goes with the personality trait of being perfectionist and being type A and overan analytical, but the type that are really wrapped up when their emotions are really wrapped up in this pain state, which it seems like you were, combined with all the responsibility on your shoulders, combined with the perfectionist type A personality would have you seeking for answers constantly looking at MRIs, looking at scans, going from doctor to doctor looking for answers and that, you know, creates hyper vigilance as well, it creates relevance in the brain and the brain is kind of like, this is a really big deal because you're turning into a really big deal. Therefore, the threat is real, the threat is massive. Let's send all these pain signals and really ramp up and dial up that nervous system. Right. All of that kind of fits the typical pattern that we want to unwind. We kind of want to unravel those things and say, if I am thinking about my hamstring pain 24/7, then I'll go for a run. I'm thinking about that pain every single step that I take. It's going to be very, very hard to recover because it's going to be very hard to convince your brain that this isn't a serious issue. And so I was going to mention, you mentioned the journaling in the 30 days and following the prompts. We found any other intervention other than that helpful in this whole recovering journey. Yeah, I was listening to, you know, I found a, there's a, you know, a, it's not a therapist, but he's just an individual who writes about mind body connection and TMS who does a daily five minute or less little podcast. And I just found, I liked listening to him. And so I started and, you know, the friend that you connected me with recommended him. And so I started listening to him because it's just free and easy to listen to on my drive, my short commute to work. So I was listening to him and I just let it put me in a good calm state and because it just, he just kept reminding you to be calm about your symptoms, not to freak out, not to, you know, there's nothing wrong with you. You are okay. It was just found in very calming and I just liked his voice. And so I actually started listening to him again a little bit this week when I've had this little bit of a flare. And I'm, I mean, even started doing some of your exercises this week. I'll be honest with you. Like I don't think that's wrong for me to kind of do some strength there. I'm doing other strength exercising now too. I definitely recognize that as I'm going to build up my running again. I need that. And so, you know, say and to brought me one of those tonal things that I'm really enjoying because it's really helping, helping me to do strength training that I've not incorporated enough. And so, but then I, with this little flare, I've been doing your exercises again just this week. But telling myself that there's nothing really wrong with me. I'm just trying to, I'm just trying to build strength and not think that I'm broken. I think it'd be helpful to mention these resources. So Emily is the one who I connected you with and she has been on the podcast previously talking about her PhD success story. She now has an Instagram. I just looked it up. So, pain explained underscore TMS is her handle and the podcast or like I mainly go to the YouTube for it. But Dan has this YouTube channel called pain free you. So I'm guessing they're the ones that you're listening to. Yes. I didn't want to know if it was okay if I mentioned exactly who they were. So, but yeah, I'm happy to give people resources because if people are going to be listening to this and be like, okay, what is it? Right, right. Right. No, I'm glad you said it. Yes. Dan, pain for you. I like his things. And there's tons more. I mean, you can find out. You can find a lot about TMS. You can even find a TMS, you know, a doctor who will diagnose you with TMS, but you don't need that if you choose to just bully, you know, unless you feel like you need that. I look, I almost went to one and I'm like, no, I don't need to do that because I have this. This is me. And I had to totally accept that that was part of I had to accept that I had that diagnosis in order to heal. And I mean, I'm feeling good. I'm definitely feeling good. And listening to your story. I think this main takeaway is going to be give something a try and see if it starts getting better. And if it does, then you double down on it. And if you start plateauing at any stage, reconsider what you're doing because even if we go all the way back and say, you got PhD initially and it just went away. Right. And you got PhD again and it just went away. Right. Things would say if you had PhD a third time, if you're okay with it, it might just go away, but it didn't just go away. It took you six months, but you tried something different. You went and saw a therapist and you went and saw the sports doctor and you went and tried to get the consults. Your initial option was manual therapy and I guess injections, which you said, I think for memory, just a little maybe got a little bit better. Maybe a little bit. A little bit. But never, never long term, nothing more than two, nothing more than six weeks of, you know, and I, and that could have just been placebo, you know, that could have been, and nothing that was withstanding and then each time the pain recurred, I realized now got worse and worse. I mean, it was never as bad as it was when I met you. That was the worst. And so that's why I was still so grateful that I found you. But just continuing this journey of this decision making. So like, even if you were to get an injection, which I don't really recommend, but even if that initially got you initial improvement, great, you know, let's, let's consider that as an option. When it gets to like maybe the second or third time, well, definitely the second, you'd consider, okay, is this really an option? Am I really getting better? Am I really getting long term results? Right. No, then you move to maybe dry needling and we probably did this way too long and similar to running through pain before seeing a doctor probably way too long. But I would say, you know, two months maximum gives something a try and that didn't work. So then you tried something new. We started working together. We said, all right, let's try the more conventional approach of slow, heavy, progressive strength training. Let's try in sliding in some running and doing a progression and things we're improving. But at a point, it probably got about 50% better and then probably plateaued from there. And so that's going to be our next decision. Let's not continue trying to do the same thing over and over and over again. Yes, we saw initial improvements, but maybe this decision now is maybe we need to change tactics. That's why we suggest the book and then you start noticing greater improvements. So now we're on to something. So now we double down on that thing and then see more improvements. And I think that whole journey, there's probably about four or five pivots in your management, which were required every section probably took a little, we'll probably add each section a little bit too long. But I think a really good takeaway for a lot of people here is don't just continue with one thing. If it hasn't been working and just expecting it to get better, we need to shift. And it could just be with something I don't recommend. It could be with something I do recommend or something in the middle. Just give it a try if you want and you're aware of the price and the risks and you're sort of weighing up everything. But when it comes down to it, if it's working, double down on it, if you find that it has worked and now it's plateaued or it just didn't work from the get go shift, make that adjustment. And I'm glad that you're in the position that you're in. So I think you've kind of alluded to it already. But can you talk about how much running you're doing or how much symptoms? I guess we'll talk about the PhD because like you say, you're managing a different issue at the moment. But when it comes to the hamstring, how things going? Yeah, pretty, I mean the PhD in that crease area of the buttocks, you know, right where we were, if I would lift my leg, you know, stand and lift of leg would hurt. That's all good. That's all pretty good. I'm back to running. I don't run today. I tried it out nine of her run two days in a row. So every other day running between three to five miles during the week. And then on my Saturday or Sunday long runs, I'm up to, so I'm about seven to nine miles right now on the, you know, what I would like to get up to that 10 mile and above. But not quite, I'm not quite there yet. And I'm a lot slower, but I don't care as long as I'm in pain as manageable. I just I don't care about my pace. And so the pain, yeah, so the, I think the pain was kind of gone for a little while and then over the last couple of weeks something has, has sneaked in a little bit, but it's more in the piriform as area, I think. But I'm just trying to, it's not terrible. It's not, it's preventing, it's not preventing me from running. And I don't think I'm doing it. It's not any, it doesn't get any worse during the run. It's just kind of this, this ache. So I'm just really trying to not think about it and hope that that helps. And if not, you know, I would may have to try some other things, but it's manageable. So I'm hoping that it continues to be and we'll go away completely, but it's definitely not, you know, it's definitely in that you always said to keep paying, I think, under a two or, and I think that's where it is. It's probably at a two and I try to just not, think, you know, think about that too much or get to upset about that. So that's, yeah, that's what I do. And I'd like to, I'd like to, I'd love to see me be able to run more and I still have a goal of one more marathon in my life, but we'll see, we'll see if it happens or not. See, everything you've told me today, I'm sure that that's within the realms of possibility. I hope so. I hope so. If someone's listening to this and they do have PhD and they are struggling, is there any advice that you might have or any take away that you haven't you have discussed? I think you just in the last couple of minutes summarized the advice. I mean, so beautifully. I mean, you summarized my whole conversation and everything I've just shared and about, you know, trying something. You know, and then not beating yourself up and regretting too much. You know, I look back at my journey and all the things that I, you know, know now that weren't the right decisions that I made, you know, the sticking with Dr. Ealing for months and months and months and months without improvement and seeking out all these passive treatments, which I know now we're not the answer. But I did it. I didn't know better. I didn't know I did what I thought was was right by seeking out Dr. after Dr. and and MRIs and all those things and I didn't know better. So I'm trying to beat myself up about that, you know, yeah, sure. I wish my pain journey hadn't been seven to eight years like it was, but it was and I'm now I'm where I am and now I don't have to I'm not going to have the next seven to eight years of chronic pain. I know I won't I won't I won't get back to that to that level just won't won't let it. So yeah, so just so yeah, I'm listening, seeking help but knowing the right kind of help and that you need and and and just kind of trusting trusting your body. The other thing that comes to mind when listening to your story is if someone is listening and they do have PhD, they're treating it like PhD and they're getting better and they're sort of doing the conventional stuff. If they're somewhat identified that they have the same thought patterns like they are hyper vigilant about their injury, they're thinking about the pain constantly. They often associate the pain with very negative emotions and it's like really, oh, I'm not seeing. There you go. The if if people are identifying those patterns in their own unique rehab, we need to do some interventions to address that like you may you probably don't even need to talk about TMS or you don't even need to have a complete buy in that all of my pain presentation is this TMS because I believe there's it can be 50 50 it can be 10 90 like it. I think a lot of people are you know they sort of have this particular scenario because obviously pain is linked with despair which when you're in despair, you don't really it's hard to focus on positives it's hard to shift your mind away from that pain. I get that as that develops into a chronic state, you're chronically fearing, dreading, very emotional gets very you know they start to become very linked. If that is you and you're noticing that you're noticing there's a lot of hyper vigilance we need to do some interventions to address that because it's going to be very hard to recover if you are noticing that you are thinking about this pain constantly and constantly and associating with you know poor outcomes I'm never going to get better and that needs to be addressed. Yes, you do you you slow heavy progressive load if that is benefiting you but we also need to address the psychosocial stuff because pain and recovery is a biopsychosocial construct very complex compared to just your traditional do you deadlifts you get better because we've got this brain that prioritises things and behaves in a way that you know perceives threat and sometimes that threat is really sensitive really over driven and we need to address it so I think that's another key takeaway when listening to your story and seeing the benefits that you've had and so if anyone else resonates with that start layering in some interventions to help. Yes, I think so and then I guess the last thing I go and mention is that you know when we speak about TMS the person that really the doctor that really coined that term is Dr. John Sarno so it's another name to to look into and his his book he's passed away he's this was back in the I don't know what decade he wrote the book but the book is healing healing back pain and so that was recommended to me too and I'm like well I don't really deal with back pain but the book is not about just back pain it should be titled something different but it's it's another really good resource healing back pain that I would recommend but it's it introduces you to the concept of TMS and has so many success stories in it too which gave me hope and so I just wanted to throw that out there as well and and for some who really recognize that the mind-body connection might be really the culprit in their in in their recovery and preventing them from recovering you know some need especially if you have a you know a lot of things to work through you know my past isn't super tragic but I mean I've had things I've had to work through of course but for some whose pain is just so chronic they would make me benefit from therapy and there are therapists who specialize in treating people with TMS I briefly looked into that and then I decided that I didn't think I needed it or had the time for it and that I could just kind of do the self-work but someone else might benefit from from you know individual counseling about their pain and so you know someone might look into that too if they really need that. Well done. Thanks for coming on sharing your story. Thanks for letting me. You've been very um appreciative of your time but also very vulnerable in this moment sharing your past and it has been a very emotional journey and sharing that is tough but I think it's quite critical because there's a lot of people going through the same stuff where they don't really be seen emotionally they don't really talk to their friends and family about it how much it actually gets them down and how much it really impacts them and so I think sharing this would help a lot of people who are listening so thanks for your vulnerability thanks for coming on and sharing your story. Yes thank you and if anyone I'm always happy to to be a resource of somebody I'm happy if you provided my email address if anybody needed to reach out to me I'm happy for that too. If you are looking for more PhD resources then check out my website link in the show notes. There you will find my free PhD five-day course other online content and ways you could personally connect with me including a free 20-minute injury chat to discuss your current rehab and any tweaks you might need to make. While done for taking active role in your rehab let's need to content like this and together we can start ticking off all of your have goals and finally overcome your PhD.