Tuesday, April 10, 2018

No Holds Barred: Making the most of your body & mind

Dr. Jason Marino with his M Train, a 40-foot RV completely outfitted as a mobile rehab.
by Blair Sabol; Photographs by Patrick Halbe

Fitness and health are big expenses nowadays.  Apparently, Millennials are spending more on spin classes, yoga studios, circuit gyms, bikes and clothes and gear than on cars and housing.  But isn’t that all good — “taking care of you?”  After all, it was Warren Buffet who recently warned the world to “Make the most of your body and mind.  What car would you have if I offered you only one — free of charge?  But this is the last car you will ever get in your lifetime, so you must take care of it.  After all, we only get one mind and body.  They may feel terrific now — but it must last you a lifetime.  Make sure you are thinking long-term with decisions that affect your mind and body.” 

No kidding — and who does?  Millennials can do all the backbends and Ironman’s they want, but once you hit sixty or seventy, nerves get frayed, muscles get ripped, and backs, hips and knees wear out or disintegrate.  And then what?

Lately, our culture has served up a crowd of “experts” from trainers to healers to wellness counselors to life coaches to gurus to drug dealers.  They all come at a cost, and none of them take insurance.  Tom Brady has his spiritual and physical trainer work out his 40-year-old Super Bowl body daily with secret strength routines and tincture drinks of certain barks and twigs.  Tom even made him his son’s godfather and “keeper” of his entire family’s well being. 
"Do wound the bark, the skin of our fruit-trees, Lest, being over-proud in sap and blood, With too much riches it confound itself ..." — William Shakespeare, Richard II
84-year-old Judge Ruth Bader Ginsburg was recently asked who the most important person in her life is. She responded with “My personal trainer.”  He keeps her “riding the bench” religiously with hefty hand weights, pushups and balance training twice a week.  By the way, the Judge does real pushups — she doesn’t take to her knees!!
Judge Ruth Bader Ginsburg “demonstrating" her side crunches.
I’ve seen elder celebrities do some serious anti-aging moves with and without joint replacements. 79-year-old Ali MacGraw and 85-year-old Chita Rivera can both kick their legs over their heads!  I observed an 88-year-old Robert Wagner get in and out of a cab recently with the straight posture and gait of a 40-year-old.  And he has a full head of hair to boot!  Not to mention 91-year-old Queen Elizabeth — okay, she has a stoop, but she worked those public receiving lines without a cane and where is her aide with a walker?  Hiding in the bushes or the limo?
No aide for the Queen!
Their accomplishments seem remarkable while the rest of us “70 and over” decrepit souls struggle just getting out of bed.  Even 63-year-old Jerry Seinfeld recently commented that he feels “awful like I’m dying whenever I open my eyes in the morning ... but once I make it to the sink and start to brush my teeth, I think I’ll live.” 

It’s all in the movement and stance for sure.  As the saying goes, “move it or lose it.”  But learning how best to move is the key.  Even best selling author Jordan Peterson listed one of his “12 Rules for Life” as “Stand up straight with your shoulders back, chest up, project dominance and move with authority with your eyes wide open.  Quit drooping or hunching, put your desires forward as if you have a right ... decide to transform the world’s chaos.”  I am exhausted just reading this.

Lately, all I hear from my aging family and friends is we all need sleep more than exercise, and how important a good Physical Therapist is.  Sleep is tricky as it comes and goes, but having a great PT might top the list above the chiropractor and psychiatrist. 

I have been to at least 10 different PT’s all over the country and though most were not stellar — each one gave me one important tip on how to move or what topical cream to apply on an aching joint.  It’s all about education, not just how many leg lifts you do.

The sad side of PT is that your recovery is often governed by your health insurance policy, and not many PTs take the job all that seriously.  Some PTs come in for 4 sessions after an operation or in rehab and show you how to get out of bed, or stand in the shower, or adjust your walker.  That’s it.  They may give you a set of safe and boring exercises (that you will never do), dump you on a stationary bike and call it a day.  It is a sad state of affairs when a PT doesn’t think out of the box, the patient gets too frustrated to come, the money runs out, and so does everyone’s dedication!

But it doesn’t have to be that way.  Doctors may have the “opening moment”, but it is PTs who follow up on the day-to-day developments.  Good PTs can be “First Responders” to all physical well-being.  Remember, they are not trainers, they are clinicians ... expert PTs really know anatomy.  Trainers may or may not, and you can forget Yoga teachers who injure their own bodies regularly.  Chiropractors are just “Band-Aids” for the moment of crisis.

When Jason and dad started their sessions together, dad could barely stand. Here he is at 95 standing during "76 Trombones" (the full 4 minutes) from The Music Man.
Personally I never experienced a great standard PT till I met 41-year-old Jason Marino who arrived on my parent’s doorstep via their orthopedic surgeon.  My Mom had broken her femur, and my 93-year-old Dad couldn’t get out of bed post-pneumonia.

Jason worked with my Dad for 5 months to get him able to stand to receive his NFL Football Hall of Fame award in 2011. 

My Dad was a horrible patient.  He didn’t want to do Jason’s leg stretches or constant living room relays with the walker.  He used Jason like Geoffrey Rush’s character Lionel Hogue — the speech therapist in King’s Speech. He made Jason listen to his speech or he would sing “76 Trombones” while he stood in front of the window.  Jason did get him in the pool a few times, but it seemed hopeless.  However, Jason intuitively knew not to push Dad, but to “listen,” and was instrumental in Dad’s recovery.  Lo and behold, Dad stood in Canton, Ohio all by himself at the Gold Jacket Ceremony, and gave a perfect speech too.  It seemed miraculous.

Dr. Marino has worked for the last 12 years with athletes, paraplegics, seniors, young kids, in clinics and assisted living.  He has done it all and now has created the M Train (mtrainmobile.com), a 40-foot RV completely outfitted as a mobile rehab.  It is equipped with all the rehab equipment, lifts, and gadgets, enabling him to come to the client’s home and get them up and out and back on their feet.
Dad angrily working out in the pool with Jason Marino, PT extraordinaire!
I witnessed him work with 68-year-old Geoff Brown who had retired after a very successful career in Missouri (“I am from Misery,” he says) who has had two major strokes.  He has seen Jason four times a week for the last 11 months. He has already lost 40 pounds, can now “bike” three miles on the arm pedaled exercise bike, and is working a full strength routine.  He is no longer a body heaped in a chair. 

Geoff’s goal is to walk again and he and his wife Gretchen have moved to Arizona to an assisted living facility so they can work with Jason and make it happen.  “The whole key is to have a goal.” Says Jason.  “Even if it is just to tie your shoes.”  Jason’s personal dedication to his clients is key. 
Jason's M Train RV ("Harvey") — Clinic on the move.
Jason setting up the days workout.
Pre-workout pep talk on the “patio” of the RV with Geoff and Gretchen Brown.
My Mom and I now see Jason once a week because every day my body feels like its gone into “outages.”  That scares me.  Yes, I walk and do yoga regularly, but Jason has worked with me on all my physical mechanics to fine-tune what causes instant pain.  He calls it “Functional Mobility.”  In other words, how to move safely.  I actually taught my yoga teacher a thing or two about not pushing people into back bends as a cure for sciatica.  Jason has even taught me how to fall (if my reflexes can respond quickly enough) in most situations.  He made some changes to the pillow positioning when I read in bed, and adjusted my computer chair and car seat correctly so that my back slump disappears.  It is all about muscle spasm prevention.
“Before” shot of me cramped in my car. After Jason’s seat adjustment.
Nowadays, I rarely get out of bed without my stretching routine.  There are other simple suggestions he made like removing throw rugs (trip prevention) and drinking organic bone broth instead of my blood sugar dump smoothie (so there Tom Brady and your twig tea!). Jason even made me change my brand of sneakers!

Jason broke his back while in college playing sports, so he knows from what he teaches.  His commitment to each patient is extraordinary — he is not the PT who hands you a copy of an exercise routine and leaves the room.  His “M Train” RV (affectionately called “Harvey”) is a mobile headquarters for healing on all levels.  His clients range from seven to 102 years old, and he sees seven a day.  That’s a lot of being on call, and getting through traffic.

“For me it is all about the body mechanics — in many cases, I have to rewire peoples minds to their bodies — so I never leave until I sense that they see and feel “the light at the end of the tunnel.”  He does that by taking videos of how you look at each session doing basic moves, so you can learn to understand why his corrections are necessary. 
Rehab — Door to Door.
His finale is always an amazing deep tissue massage, and he is The Best body worker (most good PTs are). But that is the dessert — you have to do “the work” first.  Jason is the perfect coach and cheerleader (not a drill sergeant) even on awful days.  I have never seen him at a loss for how to get you to move; he constantly comes up with new tools and routines to keep you engaged.  Most PTs don’t.
Leg Press workout with Jason.
“I always ask each person for his or her goal — what moves you — it is crucial in aging or investing in your health.  It doesn’t have to be running a 10K or a rim to rim race in the Grand Canyon (which he has done on a regular basis). Instead, it can be very simple, like merely being able to pot your own plants.” 

But he moves you on from there.
Dr. Jason Marino and gear.
As the discussion of opioid addiction takes over the current conversation, the obvious need for other pain relief choices is becoming abundantly clear. Yes, there are anti-inflammatory meds, medical marijuana, and massage.  But I see physical therapists becoming more important.  No longer will they be the “substitute doctor” or a physical “baby sitter” for a therapy session or two.  I think they will become an important “contact” on everyone’s speed dial.  Teaching people how to move and restore their bodies as they age (Hello Warren Buffett!)

After all, once your guru runs out of appropriate mantras, your drug dealer is arrested, your doctor or chiropractor puts you on a permanent hold, and your life coach dumps you for Harvey Weinstein, a good PT may be the last and best resort!
Jason “on the move” with assistant “Buddy the Elf."