How to Think Away Your Pain

: In today's episode, how to think away your pain. course, bust the widespread misconceptions. My name is Brody Sharp. I'm an online physiotherapist, recreational athlete, creator of the Run Smarter series, and a chronic proximal hamstring tendinopathy battler. Whether you are an athlete or not, this podcast will educate and empower you in taking the right steps to overcome this horrible condition. So let's give you the right knowledge along with practical takeaways in today's lesson. Welcome back. Thanks for joining me on another episode. I have been wanting to do this episode ever since interviewing Jen, the chronic pain success story that I had a couple of weeks back and she suggested a book that really helped her. It was Think Away Your Pain and she also recommended The Way Out, which I'll give that a read and see if I want to do another episode reviewing that. But I've had a flick through this book, Think Away Your Pain, and contains a whole bunch of really important information and yet decide to do an episode on it. You know well by now that I'm very intrigued on pain science. I have several pain science episodes. I've interviewed pain scientists and tried to delve into a lot of elements because, you know, I work with clients with a whole range of pain. It could be two weeks of pain, it could be two years of pain, it could be 20 years of pain and the influences around pain are just so multifactorial. It's really hard to grasp it all. sort of ties in well with research, with science and explains it in a way that maybe helps you understand in better terms. So yeah, more than happy to review this. The, like I say, the title of the book was think away your pain and structures, the pain phenomenon, especially the chronic pain phenomenon around something called TMS and Jen talked about this a little bit, but the I'll be reading like paragraphs of this book as we go through. I've tried to selectively choose which paragraphs sort of make the most sense, but there's a lot more information apart from just what I'm about to talk about. But around the concept of TMS, the book says, I will discuss the description and explanation for pain that he calls tension myositis or myoneural syndrome TMS. So it starts with tension. So this is just me talking now. So T is the tension side of things, needs to involve some sort of tension around this syndrome. And the myositis or myoneural, the M part of this TMS is, I guess, myo meaning the muscle or, he's got in brackets, or myoneural, meaning myomuscle, neural, the nerves. and syndrome, so TMS. Others have used this terminology and have also used other names including distraction pain syndrome, psychophysiological pain disorder, and the mind body syndrome. For many of these phrases, the TMS acronym works well, but whatever you call it or whatever you've heard it described, the best important fact is that your brain might very well be why you are in pain. And I guess when I've done chronic pain episodes in the past, I have tried to explain the influences that the brain has. It is a very complex, significant part in how we survive, how we have these danger signals, but then also how it can become overdriven, sensitized and irrational when it comes to producing pain and trying to, to help you heal. And the book does a very clever job at stating seven lessons in the book. So they're just kind of like statements and it then establishes like these or reinforces these seven statements throughout the book, depending on what, what's talked about. So one chapter might bring up statement number one and statement number four, just because it relates to that. And you know, mismatch it around but repeat several times just to drill in the fact that these are the lessons of pain and TMS. So I thought I'd go through those seven lessons now. So number one says that the source of chronic pain is often the nervous system and brain, not structural injury. I found one paragraph in the book that says that pain is a signal in the short term, its function is to compel you to act in one way. If the pain continues, the signalling gets more complicated and something structurally significant does need to be excluded. But often when pain persists, the message is more subtle and psychological. So another way, a roundabout way of saying, okay, pain's important. It acts as a danger signal so that you act upon it and you move away from danger and away from pain. That's the overall goal. But if pain continues... We do need to be careful and rule out certain things. We don't want to, as soon as pain arises and doesn't go away, we don't want to ignore it, we want to make sure that structurally something is excluded, making sure there's no physical damage. But once that's ruled out, if pain persists and persists for a very long time, it's now going to be less to do with the structure and more to do with the psychological influences. So when I say psychological influence, I'm talking about your thoughts, feelings, emotions. So that was statement number one, that the chronic pain is often the nervous system in the brain and not a structural injury. Statement number two, the context and the interpretation of the pain by the patient and its perceived significance is crucial. So I've talked about this way back in the early days of the podcast when I had those pain science episodes. Um, highlighted the importance of context and interpretation when it comes to pain. Um, if we were to put as an example, if someone has low back pain and they're, they have a close relative that has chronic crippling low back pain, tons of surgeries on their lower back, and now they're bound to a wheelchair. That is a completely different scenario compared to someone else who has the same. low back pain, the same structure, the same intensities, everything. But they've had, they've gone and seen a health professional that said, everything's fine. Don't need to worry about it. Just do these stretches and exercises, return back to your normal activity gradually and everything's going to be okay. There's no structural damage. Everything looks great. The context has changed in both of those scenarios and the outcome. how severe the pain is, how quickly they are to recover is going to be completely different. Structurally identical, but context has changed. And also their interpretation of the pain has changed. So we need to be very careful with that. Statement number three, psychology and education can change the mind, brain and cure pain, not just manage it. So it's... An interesting concept or hard to get your mind around that you can become pain free just through education and your mind alone. People think that they need surgery or they need to do strengthening exercises. But if your presentation is fitting more to do with this TMS, it is just education, working on your thoughts, feelings, the mind brain connection, and that can help cure your pain and not just. not just manage it. We're going to talk about treatments later on. But that's statement number three. Statement number four out of seven is that pain does not always mean disease or damage. You can have pain arise and there'd be nothing wrong. Sometimes you can have pain arise and there is something wrong. But pain does not always mean disease or damage. Number five. The severity of the pain does not always correlate with the severity of the condition or the potential for damage to the body. I've explained that just before. Like you can have a large severity of pain based on context. You could have like, you know, I've just had Mackenzie. Mackenzie's turned three months old now and my partner Megan going through childbirth. A lot of pain, but no... Damage, there's no threat. There is this physiological pain that, um, is there, it's there to be a guide. It's there to help, but it's not the, it's not that anyone was in real concern of things going wrong. Things were going right, but this is the, um, process that we go through. And most, uh, moms or. Expected moms, I should say, um, you know, expecting this pain and you know, they're not concerned when there is labor pain. So just a example based on what my life is like at the moment, where I'm up to number six, pain signals in brackets sensory signals are a two way street. The mind brain plays a crucial role in what we feel. So this mind brain they talk about a lot. And it's important that we do think about it as a two way street, because some people just think that pain is from receptors in the skin that then, you know, go up to the brain and produce a severity of pain. Doesn't really work that way. All the, um, yes, nerves can be fired at, say your foot and travel all the way up to your brain in order to produce pain, send signals back down and create the sensation of pain. but you can have pain in your foot without any receptors going on. We know the phantom limb phenomenon when amputees don't have a leg and they have an itch in their big toe or they have pain in their heel or they have tightness in their inner ankle in a foot that's not there. So there's no signals that are traveling from that phantom limb, but the brain is creating it. So this is a two way street. over on page 49, I've got this in front of me, they use an example. And they say, for example, a young father has lifted his three-year-old son countless times. One day, he lifts his son exactly the same way as he always does, but does so during a period of his life when he has been fretting about losing a job promotion. This time, his back muscles, primed by the stress of his work situation, go into a painful spasm. Because of his personality and his current work pressures, he might worry much more than a person who tends to be less hard on himself. He quite naturally begins to worry that something is wrong with his back. If the young father responds to this painful back attack with a lot of worry, fear, and emotional amplification, the problem may persist for a week or even longer. So... Looking at this two-way street, this is factoring in personality traits, factoring in worry, fear, concern, and this is not only amplifying pain, but increasing the odds of pain prolonging. So very important when it comes to that, have I gone through, we're up to six out of seven. So the seventh statement or lesson that this book constantly refers to, says that mind body pain keeps coming back until you are firm in your belief that there are no physical causes. So you can read this book, you can act upon it, you can start doing the lessons and keep in mind that you just won't see a complete resolution if you still have those old beliefs. One thing that was evident when talking with Jen was her chipping away at some belief that there was something physically, structurally going on, contributing to her pain. She had to rationally think through some things and it took a long time. Took a long time for her to convince herself that maybe there was something else going on, maybe it was this TMS instead of something structure, structurally going on. And, you know, every time she just chipped away at that belief until she eventually truly believes that it is the TMS and not something structural. So very important there. I thought I'd come up with this next topic called susceptibility. Those who might be more susceptible to an injury developing into this TMS scenario, because we do have pain. We roll our ankles, we tear muscles, we get stress fractures, we get back pain, like all of these sorts of things happen. And definitely that can start off with something structural. A lot of people say, when I introduce some of these concepts, they say, Brody, you're telling me it's all in my head, but you know, I sprinted and my hamstring tore and the images showed that there was a tear in my hamstring. Definitely the case. Definitely something structural was going on in the early days, but that was 12 months ago and the body heals. The body. does a really good job of structurally healing things. When it comes to tearing a hamstring muscle, you know, there's a lot of blood flow to that area that is healed in, you know, six weeks maximum. But we're now 12 months down the track and you still have pain. So we still need to consider other influences that are now contributing to this persistent pain. So let me just flick across to the page that I have marked. When it comes to susceptibility, they have a look at certain categories, particularly talking about personality traits and traits that are stemmed from childhood. They talk a fair bit about childhood and how people have grown up to, you know, behave a certain way, think about pain a certain way, but I just thought I would highlight a few of these things. So some personality traits from childhood that may be may lead you to be more susceptible to developing TMS. So category number one was the pressure cooker. And this is one category that involves people who describe a happy, loving childhood, but with tremendous pressure from parents who expected high achievement from them. That's just a short little summary. The dysfunctional situations is another category and. includes individuals with more challenging childhoods, which involve involving families that were divorced or were had drug issues, alcoholism and other addictions as part of the family situation. The third category, they've just labeled round pegs in square holes. Still another category of childhood experience includes people who just did not quite fit in with their This is the most challenging group to treat and individuals who have experienced cruel childhood with emotional and physical abuse, sexual abuse and abandonment. And so this can really trigger a lot of what they're called tension, emotional tension, those sorts of things that need to be resolved or at least need to be confronted if we were to eventually overcome this TMS type of pain. So there's just some brief categories. Like I said, there's a lot more to talk about here, but they also have these helpful questions for you to ask yourself to see if your personality is sort of linked to your pain or if chronic pain is linked to your personality. And they ask questions like, are you a perfectionist? Are you a people pleaser? Are you hard on yourself? Are you highly responsible for others? And are you sensitive to criticism? By asking these questions and observing the response, you can determine whether you have a T type personality. And talk about these T type personalities. Um, and also talk about the alphabet soup for T type. And they call it the alphabet soup because it's, it stands for, oh, they've got this kind of, um, acronym. I don't know if you would call it acronym, abbreviation. I don't know what the term is, but M N O P Q R S T other letters. And M is for the motivated achiever. I'll just go through these, um, the rest of these letters. Nice and good ish is someone who is driven to perform good acts. Order prefers order, not necessarily orderly, but prefers order. P perfectionist, a people pleaser. Q is quick to judge. R is responsible. S is self critical, one who is hard on themselves. And T is the T type personality. It then follows up with another topic called managing your type T personality and says, do you have to change your personality to succeed in treatment in this treatment approach? Can you even do this? Is this even possible to change your personality? The answers I give patients are no and not that much. As one looks deeper to understand the roots of these traits, I do discuss learning how aspects of one's personality. So not changing someone's personality, we're just identifying what elements of those personalities aren't serving them as sort of dialing them down just to dampen those thoughts and tendencies that people have with certain personalities. They also have a very lovely questionnaire, which I'll flip to now. It's called the full TMS questionnaire. And has you ask Yes, no, or answer yes, no, or certain ranking questions and Jasmine defending the castle. Okay. I think she's settled down now. Okay. Uh, how many questions are there in this questionnaire? There is seven plus. I'll explain that in a second. So let's answer, as you're listening to this, answer these sort of things yourself. Have you noticed a relationship between your pain and your emotional state and stress level just prior to the onset of pain? Do you describe yourself in general as being very hard on yourself, highly responsible for others, very thorough, orderly or perfectionist? Number three. Have you suffered from other tension related illnesses? And they talk about hives, eczema, rashes brought on by tension, irritable bowel, gastritis, reflux or heartburn, tension or migraine headaches, unexplained prostate troubles or pelvic pain, TMJ, so your temporomandibular joint, so your jaw joint, teeth grinding or plantar warts. Number four, have you been told regarding The cause of your pain that there's nothing that can be done surgically. Or there's nothing wrong, or it's a soft issue problem, or the cause is degenerative changes. 5. Do you spend a fair amount of time during the day thinking and worrying about your pain, researching an answer and obsessing about its cause? 6. Have you tried several different treatments or approaches for your pain and received only temporary or limited relief from each of them? Number seven, do you find that massages help your pain significantly or that you are quite sensitive to massages in several parts of your back or neck? So then we, there's sort of like a point system towards it, but if you've accumulated a lot of points, you'll be highly probable for TMS. If you're sort of in this mid-range, it's possible TMS for being a candidate. Um, and if you're low on this, it's probably not TMS. But if you do fit in the middle somewhere and you're still not sure it's possible, uh, maybe a possible candidate, uh, the book has three extra questions for you to answer. They say, does the pain ever move to another location in your body or jump around? Have you noticed the pain improve? when you have an other tension related illness. Has the pain significantly changed or gone away when on vacation, away from home or while distracted? If you've answered yes to any of the questions above, you might be able to point to TMS as a source of your pain. The traveling or like vacation is an interesting one because a lot of people can rationally think through, oh, it's just because I am in warmer weather, it's more humid. I'm not at my desk as much. I'm not sitting as much. I'm not walking as much. Like when you're on vacation, you change a lot of how you behave and a lot of things that you do and also the climate. And so some people can think about, okay, my, I'm significantly better because of these changes. So, you know, very hard to, to draw these conclusions, but, um, nonetheless, the next topic I wanted to talk about was, okay, well, what can we do about it? If we've identified. myself as a TMS candidate and I have this chronic pain, what can we do? Let's go back to page 52, which is I've got marked because it talks about training your brain to stop hurting you. And it essentially says, your understanding of why you hurt may have been wrong all along and this may be limiting your ability to improve. This is such an important point that I'm going to keep repeating. Your basic understanding of why you hurt may be wrong. This may be limiting your ability to improve. The techniques and treatment approaches that follow require you to play an active role and to think differently. Then in the chapter that talks about erasing your pain, it's, well, the chapter's titled, erasing pain by keeping a journal. Now, Jen mentioned this as well in her, success story talking about her journaling. And now that I've read the book, I sort of understand more about it. So the book says, I encourage people to write about feelings and to write daily if possible. The ideal time is one when you are alone in a room without human or electrical distractions for about 15 minutes. Start by writing about something that made you upset or happy that day. Yesterday if it is early in the morning. Let the writing flow. Don't worry about grammar or punctuation. If your writing comes to a natural stop, reflect on your answers. Is there a connection here with your past, your childhood, with writing you did the prior week? As you obtain insight, make an attempt to go beyond the expressive writing and make connections between emotions, pain triggers, and the past. Finding patterns will add to your observation If you are using, well, I should say here, the author always talks about this mind, body, workbook that he has. Says, if you are using the mind, body, workbook and find you have more to say about a particular question or subject, continue on another page or another blank notebook. If you are recording your thoughts on a smartphone or other device, that's fine too. It is important the feelings find a form of self, of semi permanence. in written or recorded words rather than just thoughts. Research shows this to be more effective. So we don't just wanna think, just be like, oh, I don't wanna write down things in a journal or type things out, let me just think about it and process them. It's gonna be a lot more effective if you put them into words, put them on paper or put them onto your phone. They do mention some research here and said that there were some authors summarized the breadth. the breadth of positive findings for expressive writing, such as journaling, and they wrote that the benefits of this writing included fewer illness-related visits to the doctor, blood pressure improvement, lung function improvement, immune system function, and improved sporting performance. So just listing some of the benefits while journaling can also be very beneficial. Okay, so journaling really important when it comes to the treatment and healing. But there's also another positive thing in here, which the book talks about if on chapter 12, they talk about 12 stages of healing. And so let me just flick to that because we're going to go through all these 12 steps and I'm just going to briefly try and cover them. Um, sorry, it was chapter 10, the TMS 12 stages of healing. So let's go through each one individually. And I've sort of highlighted some paragraphs that we can go through. So stage one, acknowledge that existing approaches are not working. And it talks about things like medication, physical therapy, chiropractic, acupuncture, exercises and mindfulness. I have utilized most of these approaches in patients with acute or new back pain or injury. Most of these approaches work or seem to work in people with acute and subacute pain. Another thing that works well is reassurance that there is nothing structurally wrong with the patient. A gradual return to usual activities is possible. In fact, this latter approach is often the most effective, clearly the simplest and most cost effective. So... Just starting off the chapter by acknowledging that yes, these things do work mainly for acute and subacute pain. And so we shouldn't really dismiss it, but it's when circumstances change that we need to dive into stage one. Each of these philosophies implies that something external needs to be done to get well by someone or by someone other than oneself. Step one is to acknowledge that the approaches You have been trying so far have not worked to eliminate your pain. This is, so I've just briefly just covered a few of these things. I've literally just skipped through pages just to get through that first stage. But, um, essentially saying, don't just keep doing the same thing. Uh, I've seen a lot of people just do the same thing. Some people have PhD and do body weight bridges for 12 months and wonder why they're not getting better. Except that what you're doing isn't working and that something needs to change. Stage two, becoming open to a new paradigm of diagnosis and treatment. Openness is akin to readiness in the psychological model of how we change. It devotes a willingness to embark on a new path to turn in a different direction and to hear something that could not previously have been understood. This is really important because this is a concept that a lot of people dismiss. Jen dismissed it several times. then tried to dabble into it and then put the idea by the wayside several times before eventually picking up and committing to it. And continues to say that, a good number of my patients first were exposed to the TMS concepts by reading the book by John Sarno and others such as myself. It was months and even years before they decided to apply these principles or seek a diagnosis. Why had they not done so immediately? I've heard the following and it gives a list of quotes from people who have taken a long time to accept this. They say, it didn't make sense at the time. The ideas made sense, but I decided to get an epidural instead. I wasn't ready. My wife was skeptical, so I tried a different kind of acupuncture. So, random way of saying that these people are accepting it, but or not accepting it or accepting it and others are being dismissive and they kind of just want to go with the more, um, mainstream approaches. Um, so, and I totally get it. That's something that we naturally gravitate towards. Um, okay. Stage three, evaluating the TMS diagnosis with an open mind. I think that's a pretty key one that, you know, we need to be open-minded if we were to eventually accept this and. do something, act upon it with full belief. Stage four, accepting the diagnosis intellectually. So there's a few things here that, a few examples. So while we say intellectually, I would talk about like rationally talking through it. Jen mentioned that in a success story. There was some things that just didn't make sense from a structural point of view, but made a ton of sense from a TMS point of view. And so she was intellectually or rationally using this belief to sort of instill upon her. So they say some examples. So you can say that I have you can say to yourself, I have the TMS personality. So going through that checklist I mentioned before and being like, Oh, I'm a I'm a high candidate for this type of thing. My pain started right after a relationship breakup. I am better on vacation. My MRI shows nothing more than is typical. even in average patients of my age without symptoms. And I have very typical TMS tender points when the doctor examines me. So another way to rationally go through things. Stage five, accepting the diagnosis in one's gut or heart. The book says, finally, when you viscerally accept and believe in this diagnosis, you can stop worrying and being afraid. You can channel your energy more constructively and not keep attacking yourself. You can learn more about your own emotional life and stop suppressing the portions of it that are dark, self-loathing and frightening. By acknowledging it all, you can be free of pain. And they also say in this little section, how do we get to this level? They say read, re-read and immerse yourself in the materials available. So really, comprehensively understanding the book and other similar materials. Reflect upon yourself, your personality and circumstances. Ponder the logic of this diagnosis. Another one, a medical doctor knowledgeable in TMS can help greatly by looking in your eye and giving you a clear diagnosis. And lastly, look for your resistances, if any, and evaluate what is holding you back. Then get the information or support you need to bypass this block. There's the last one here. Take a leap of faith. It is safe and you can always go back. That's a fair point as well. There's no risks to this. Sure, you have to dive in with full belief, but if it doesn't work, you can always go back to something else. There's very, very little risk involved in this. Okay, stage six. Thinking psychologically, not physically. I think we pretty much just like hashed. most of that out. There's a few diagrams about the neural pathways in this, which you know, we can't do in an audio format, but stage seven, dealing with doubt. Sit down and write a list of reasons why you accept the diagnosis and why you believe in it. The doubt will fade away as you fight back against its regressive force. Move forward with a deeper acceptance of the diagnosis. So this is just getting you to that next level. It's like Okay, write down, almost doing this, you can also do that intellectual thinking or rationalizing, but there's always gonna be some doubt there. So what you can do is write all these things down and continuously tell yourself why this is the case, why you believe this to be true about this whole TMS diagnosis, and eventually the doubt will fade away. Stage eight, increasing your activity level. So they have an example of a runner, thankfully enough here. and says, I am often asked, I am often asked, so can I start running now? A former runner asked me this because for three years he had not even been able to walk as much as two miles. But now that he was feeling much better from his TMS work, he wanted to resume running again. I told him, yes, but I urged a cautious approach for this return to activities. I held out to him. the very real hope that he would be running soon. First, I wanted him to try fast walking and more journaling and more TMS related reading and light jogging. When his acceptance of the diagnosis was stronger, he could try a short run and then gradually progress to longer ones. So just a good example, I'm glad that there was something running focused in here. Okay, stage nine, flare ups, very, very important. Just as doubt is normal, flare ups are natural and are working within the TMS diagnosis. So just because you have flare ups doesn't mean that what you're doing isn't working. It's all a part of the process. Pain relief is not a straight line and is more jagged like a lightning bolt in shape with ups and downs. Accept this and understand that it is normal. A flare up can mean several things, but it does not mean your life is ruined and the pain will be with you forever. So what, there's a few things that I just thought to underline when they talk about, okay, how should you respond to a flare up? First of all, step one, notice it, then talk about it attempting to think your pain away. It also mentions, gently explain to yourself that this is not from damage. It is from stress and worry, from anger and fear. Also a good reminder, when everyone When anyone has an unexplained flare up that isn't like mechanically bound, I always ask like, what's going on? Is there, how did you sleep? What's your emotional state like? What's your hypervigilance like on that day? And often there's a connection with worry and fear on that day for whatever particular reason. Okay, stage 10, we're almost there. Friends and family. Just as you are adjusting to the lack of pain and your increased activity levels, your friends and family and coworkers may need some time to adjust to the new, to the new, to your new you. And also really importantly, talks about, like say your family and your coworkers, if you're healing from low back pain, they're always gonna ask when they see you, like how's your back? How's your back pain? How are you feeling today? All those sorts of things. This is where you need to... Reinforce to them. Oh, yeah, I'm doing better things. Can we shift to another topic as well? Or you can be a bit more abrupt and say let's talk about something else because you perhaps around your life with Being so long in pain. You're sort of being labeled as the pain patient or you know, the person this person has chronic pain And all your friends and family they're just looking out for you. They're asking they're curious about you but won't necessarily help the recovery process if you're constantly reminded and constantly asked how's the pain. So just allow some time and communication for your friends and family to adjust to you not being in pain. Okay, we don't need to talk about that anymore. Let's talk about something else. Stage 11, TMS can move or change to other symptoms. So change in terms of changing location and changing to other symptoms being like, oh, it was a burning, now it's a numbness, or now it's an ache, it was a throb, now it's a sharp, changing symptoms that way. TMS pain can move around. It's a tricky condition. For example, when patients tell me that their back pain has gone and they're mysteriously having pain in their elbow, I deem that as progress. They say that TMS migrates rather than disappears for multiple reasons. Ongoing fear. of a structural cause, ongoing ignorance of the emotional issue in one's life, doubting and not fully accepting the diagnosis of TMS, or needing more time to process the message of TMS and learn to master the methods of healing. Okay, we're almost there. Stage 12 is about teaching others to heal. And so it's once that you have a deep understanding and it's really helped you. It is now time to help other people that might have TMS or at least open the conversation or point them in the direction of some other resources. And, um, if it's really helped you, it might really help them. And then they might spread the word to other people. It's really tough. Some people can instantly dismiss it and never pick up a book again, but at least you've tried. Have I got anything else written down? The, the, the rest of the book talks about, um, the science behind it, what research is, talk about case studies, talk about affirmations and self-talk, they talk about other practical ways, affirmations to reduce anxiety, different types of physical activity that you can do, all those sorts of things. And this is just a really, really brief summary of this book. Highly recommend if any of this has resonated with you or you're looking to give it a try. First of all, read the book. Second of all, message me and see how you go. Cause I am extremely curious about these sort of topics and would love to know if you've had any success with it. Um, if you, it might take a bit of time, might involve a few hiccups here and there, but if this episode and the, this book has helped anyone, I'd really love to hear about it. So maybe if you know someone who might, who maybe not point them to the book, maybe point them to this episode first. where they can just have a listen for how long have we been recording for about 45 minutes. And if they just listen at two times speed, that's, you know, not a lot of time spent and not a lot of costs like a book might be. So point them in the right direction, help someone else out. Hopefully this can help a lot of people. So thanks for joining me on today's episode and we'll catch you in the next one. Thanks once again for listening and taking control of your rehab. If you are a runner and love learning through the podcast format, then go ahead and check out the Run Smarter podcast, hosted by me. I'll include the link along with all the other links mentioned today in the show notes. So open up your device, click on the show description, and all the links will be there waiting for you. Congratulations on paving your way forward towards an empowering, pain-free future, and remember, Knowledge is power.