Podcast Transcription: 3 Things I Wish an Orthopedic Surgeon Told Me About My Injuries

Ted Ryce: So why doesn't physical therapy work for people and for you? And I've tried a bunch of physical therapists for my injuries over the years, and it didn't really work. Well, I've noticed a trend over the past few years from working with clients. I have been running a body transformation program, coaching, uh, program for the past, I don't know, maybe seven years, no, eight years now. 

And it's un- it's, it's actually a bit common for clients to come with either previous injuries or to experience some issues while we're working together. And during the past couple of years, I really noticed a trend. Clients would have a previous injury start to flare up while they were losing fat and pushing hard in the gym and, or maybe running on the off days in between gym sessions, and they would end up with an injury. 

Nothing major, but something that became more than something small and something that needed attention. Then those clients would go see physical therapists. So I had one client who went to see a physical therapist after pushing himself a little too hard on the machine bench press and hurting his right shoulder. 

I got another client who had his low back and his shoulder flare up. I had another client who, um, was-- he started having knee issues when he was working together with me, uh, when he was running on the off-- from running on the off days. I had another client who came already with shoulder issues because she played tennis very competitively. 

And they all went to physical therapists, and the physical therapists all did kind of the same thing. They gave them exercises And they started to feel better, but they could never get back to the level of performance from before the injury started flaring up. And I started saying to myself, especially as I was making my return to jujitsu, like, "What is going on here? 

Are people just... You, you just break something and it just never gets better?" Because I was kinda there in the sense that, i- in case you don't know my story, I just got my Brazilian jujitsu black belt last year. But before that, I was, like, planning my comeback, and it all started off in 2024, uh, the beginning of 2024, where I got 750 million stem cells injected in, into my body. 

And I thought it was gonna... Actually, to be completely honest about this story, I thought I made a big mistake when I did it. However, then I started feeling, my joints started feeling better, and then I had big hopes and thought, "Oh, maybe this is gonna fix my injuries." And it helped, but it never got me back to where I needed to get to. 

And then I started asking the question, "What is going on here? Is it just there's no way back?" And then I started asking, "How are physical therapists working with million-dollar athletes? How are they getting athletes back to playing their sport again? What are the best in the world doing? How can you go through a surgery and then get back to playing a sport at a high level? 

And that's where things began to make sense for me. So I even changed my com- my, my business model. In other words, we, we used to be Lean After 40, now it's Strong and Pain-Free After 40 because of this big gap, because physical therapists, they just don't get you to where you need to go. And in this video today, in this podcast today, I wanna talk a little bit about the lessons. 

So let's hop in, 'cause I've, I've done a bit of ster- uh, storytelling here, but I wanna tell you, number one, it is not your age or it's not wear and tear. That, that's a myth, and I wanna be really clear about what I mean by this. It's not a myth that if you get an MRI, it's like, "Ted, it's not a myth. I got an MRI. 

There's arthritis in my knee." I have... I've had arthritis in my knee since my early 30s, chronic Malaysia and meniscus tear, so I've had arthritis for a long time, and my knees don't hurt like they used to, and it's certainly not because of age, but it's also not because of wear and tear. So there is some wear and tear in the sense that if you take a random group of people, let's say 100 people, and just do MRIs of common injury sites, you're gonna find things. 

You're gonna find rotator cuff tears in their shoulder. You're gonna find herniated discs in both their cervical and lumbar spine. You're gonna find some, you know, labrum issues in their hips, and meniscus issues, and arthritis in their knees. But you know what? A significant amount of those people that show MRI or, or degenerative changes or even full-on injuries in the MRI are going to be pain-free. 

So what is going on, right? What is going on with this? And what I'll tell you is we now understand that the issue is about something, a concept called tissue tolerance. So just think about this. I, I used this the other day. Think about this. I can take a... Let's just take a piece of tissue. And if you just take the tissue in between your fingers and you just hold it, there's no stress on the tissue, but start pulling on the tissue, and the fibers get taut. 

Well, pull a little bit more, and the stress increases, and you can keep increasing that stress. Imagine you just increase it very slowly to the point where some of those fibers start tearing. That's what happens to a lot of us. We-- Some of us get contact injuries. In other words, you know what? I was playing I was playing soccer and then I slid tackle someone and my ACL tore. 

Or if you watch the Conor McGregor fight, I know it's very contro- uh, controversial to talk about it, but he landed wrong on that leg and tore his ACL. But a lot of us, we don't wake up... Or, or I'm sorry, we don't know exactly what happened. We just wake up and our back hurts, shoulder hurts, knee hurts. Well, you can cause some damage to your tissue and not know it till the next day. 

And tissue tolerance is simply defined, or simply defined, is the amount of load that a tissue can take before it starts getting irritated and causing pain. And another important concept is Tissue capacity. So we also know that we have a tissue tolerance and for example, I, I wanna give an example of this. 

I had a client whose knees hurt every time he walked up the stairs because the tissue tolerance of the, the... of his knees, let's just keep it simple, because you got a lot of connective tissue in your knees, a lot of different things that can hurt in your knees, probably things you never heard of, like the fat pad in your knee is, is actually, uh, can be really painful. 

So he was having pain walking upstairs, but we worked together and improved the tissue tolerance and capacity to the point where he could walk upstairs pain-free. So did he get older and that helped? No. Did we reverse his age? No. Did we, you know, adjust the alignment of his hips? No. Did we correct his biomechanics? 

No. What did we do? We specifically targeted the tissue tolerance of his knees, I used a combination of isometrics tr, uh, and traditional exercises, and got him to the point where he could walk up the stairs pain-free. And which is good because he's only in his early 50s and that's not a good place to be in your early 50s. 

And this guy, by the way, was also training with a personal trainer who was not doing a good job with him. So that's an example of tissue tolerance and also how you can affect tissue capacity. But I wanna tell you something else. Tissue capacity and training it to become better is not simply a matter of going and doing some exercise. 

For example, you might go to PT, let's stay with knees. You can go to PT, you can do the banded knee extensions and the clam shells and all the other things, and there's nothing wrong, those are great exercises for a specific period of time, but you need to progress from that. But what do most people do? 

They just go back to training. They try to go back using the same load they used before, same amount of sets, reps, exercises. And what happens? Your knee flares up. Could be your shoulder, could be your low back, but it flares up. And when you start to train for tissue capacity, it's completely different. I wouldn't say completely different than training your muscles, but it's different enough that you can't just go and train and have your knee get better Or shoulder or low back or elbow, whatever it is, you need to approach it differently from a different perspective of rebuilding tissue tolerance. 

And what does that mean? I'll tell you what it means, and you can even... If you're clever enough, you could even, you know, do this on your own. It's like do the amount of exercise that makes your knee or shoulder or, or low back feel better the next day, and that's how you know if you're doing things correctly, and that's how I know if I'm getting anywhere with a client as well. 

When they do something, is there at least zero change in the amount of pain they feel in the morning and function, or is there an improvement in the amount of pain they feel and the amount of function they experience? For example, let's say you do a rehab program with the knee extensions and everything, and then the next day your knee hurts more. 

In fact, when you squat down, you can normally come all the way down, but now you can only come halfway down because now there's, like, some sort of pain in your knee that wasn't there the day before. You messed up is what happened. And the answer is understanding, well, what happened there? What are the things that I did? 

What specifically irritated my knee? And then let's regress things a bit until the knee calms down, until we get rid of the pain the next day, and then build from there. But I'll tell you something. I've known this for a long time, for, I don't know, maybe 10 years, and I've been... I've made a name for myself back in Miami when I was doing, um, personal training. 

So I guess, yeah, about 10 years ago, I would help people with injuries. I was known for it. But I could not get beyond a certain point because I didn't have enough knowledge, enough experience to do it. And back 10 years ago, the information was quite different. There have been, in the past decade, huge breakthroughs in sports medicine, and it's just, it's an incredible time to be alive for health and fitness. 

We just start... We've been learning more and more and more, and more importantly, it's like we can fix things we thought weren't fixable. Kind of like what I'm talking about here. So anyway, we've talked about how it's not wear and tear, it's tissue tolerance. We've also talked about how you can rebuild tissue capacity. 

So tissue tolerance is the amount of load and stress, you could say, a joint can take before it gets inflamed. And we can say tissue tolerance, uh, uh, that's what tissue tolerance is. Tissue capacity is the ability of that tissue to be trained to the point where you can raise its tolerance, and that's a very tricky thing to do, but I just explained to you how to do it, right? 

You just need to have enough information, enough knowledge to like, okay, well, what am I gonna try here, and then build from there, which, you know If you have the time, go for it. But if you want fast results, then we, we'll talk about how you can, uh, reach out and, and we can have a conversation about your situation. 

But before we do that, though, I wanna talk about the third thing, which is your overall health matters. So this is something we're starting to really understand at a deeper level, which is if you are someone who is in pain, and let's say you're doing physical therapy, and let's say you're working with someone, the very rare chance you're working with a good physical therapist, but, you know, let's say it's not working. 

And let's also say that you're 20, 30, 40, 50 pounds overweight. Let's also say that maybe your blood sugar levels are in the pre-diabetic range. Like maybe you have a 5.6 on your hemoglobin A1C, maybe 100 on your fasting glucose. Well, guess what? That metabolic dysfunction, the blood, uh, sugar issues, it's not just messing with, you know, all really all types of things, right? 

Because it, uh, because your arteries will also get stiffer, your blood pressure will go up with poor metabolic health. But more specific to what we're discussing today, we know that higher than optimal blood sugar levels create an inflammatory environment. What does that mean? Well, before we thought that running was, uh, caused arthritis because of wear and tear, and now we know runner's knees actually are better off than the average person's. 

Okay, so what's going on? Well, if you have, um, if you have metabolic dysfunction, it causes an inflammatory environment in your entire body, which is including your joints. In fact, people with obesity have higher rates of arthritis even in their hands, right? I read a great paper that was talking about people don't walk on their hands. 

That was, you know, medical r- uh, uh, researchers trying to be funny, but basically saying everybody gets the idea that if you're 20, 30, 40, 50 pounds overweight, that your low back is gonna experience more pressure. Your hips are gonna have to bear more of that weight. Your knees, we know that every pound of extra weight that you hold adds another four pounds onto your knees. 

But what we didn't know until more recently is that this metabolic dysfunction, insulin resistance, causes issues, inflammation in your joints. And even worse is that- Your tendons, which by the way, tendon issues don't show up the same way that they do on an MRI. A tendon tear might show up, but poor tissue quality of your tendon, they're using UCT, which I forget what exactly what that stands for, but it's like color-coded ultrasound to measure tendon quality right now. 

Again, huge breakthroughs in, in medicine with, uh, rehab science and everything. And anyway, what we're starting to see is that we're, we're learning that not only does it cause inflammation, but tendons start to get weak and brittle due to poor metabolic health. And guess what? How do you know if you have poor metabolic health? 

Well, how many steps do you get per day? Is it 5,000... 5,000 or 6,000? Maybe less. How big is your belly? I- can you put on a T-shirt and have, have it not pop out Well, high, high probability you've got some metabolic dysfunction going on. So if you have a belly, get rid of it. And those are, like, the three things that I would tell you. 

Now, I d- I didn't have a belly recently, and by recent I mean the past few years, but I did do blood tests and saw that I had... 'Cause, 'cause I don't want you to think I'm pointing fingers at you here or making fun of you even, and, like, I'm a perfect person. I'm not. I had a few points in the past couple years where I'm like, "Wow, my blood sugar is higher than normal." 

I mean, my hemoglobin A1C was 5.5. Not pre-diabetic, but a lot... A- and fasting glucose in the 90s. Not pre-diabetic, but i- it's, it's close, you know? So, uh, I've been guilty of these things myself, and, and, and that's why I'm here to tell you. Understand injuries are not your age. It is not wear and tear, at least in the sense that we think it is. 

It is you have lost tissue tolerance. It is also that it's the information on how to rebuild tissue tolerance is very poor at the moment, and it ain't on social media, right? The people I'm learning from, that most of them have PhDs, work with million-dollar athletes, and they have very small social media followings. 

And they're not exactly the most exciting. So even if you saw some of their posts, you'd be like, "Eh, this is boring. Let me go see, like, the shirtless guy or the girl in the workout shorts, you know, talk about injuries and, and show the one weird exercise to fix your low back or whatever." Right? It... Th- they're not... 

The information is very bad, especially if you're getting your info from social media. And then the third thing is, if you have health issues, it's playing a role in your injury, in your injury recover, and your ability to rebuild tissue tolerance. Of course, as you start to exercise more, your insulin resistance improves. 

But, um, yeah. So that's what I would tell you. And if this is all like, "Man, I don't want- Uh, uh, now some of you are gonna be off to the races having conversations with ChatGPT and Claude or, you know, whatever AI you might be using. Fantastic. Go and try and fix it for yourself. But if you're a successful person over 40 or... 

a-and you don't have time to do all the research because you're running your business or you're an executive or maybe you're a physician, maybe you're an attorney, and you don't want to have a side hustle where you're trying to figure this out for yourself because despite your high intelligence and discipline and everything else you got going on, you're really busy and you don't have time to, uh, you know, do 100 hours of courses like I have to figure this stuff out, and the time to not only learn it, but experiment on yourself to figure it out. 

If you wanna skip all that and get fast results better than what your PT, your neighborhood PT has done, then let's have a conversation. Would love to talk with you. Go to legendarylifepodcast.com/knee and book a 20-minute blueprint call. That's legendarylifepodcast.com/knee, and let's have a conversation. If I can help you, I'll tell you. 

If your situation is too, too much out of my league, I'll also tell you. I'm very, um, you know, I only want winning clients, winning testimonials, and I think part of winning as a business, by the way, is also telling people when, when it's not appropriate to work together. So that is it for me. I hope this helps, and I hope you're excited about the direction I'm taking here as much as I am. 

Would love to hear from you as well. You can always email me or reach out to me anywhere on social media @ted_ryce. Have a great one, and speak to you on the next episode.