Menopause Joint Pain: What’s Really Causing It; Does Cortisone Injections Help with Stacey Roberts

What if pain isn’t just “wear and tear”… and aging doesn’t have to hurt?

In this episode, Mary sits down with physical therapist and nurse Stacey Roberts to unpack a completely different approach to pain-free living.

After decades in traditional medicine, Stacey began questioning why so many patients weren’t getting better. What she discovered changes everything: pain isn’t just structural—it’s influenced by your brain, hormones, gut health, and even your mindset.

We dive into her discovery of a non-invasive treatment,  SoftWave Tissue Regeneration Therapy (TRT) and why she became the first clinic to purchase one. She will also share the Pain-Free Formula and explain why common treatments like cortisone injections may not be the best solution we once believed.

Connect:

• Stacey's clinic: https://newyouhealthandwellness.com
• Book: The Pain-Free Formula: Solving the Puzzle of Muscle and Joint Pain Without Surgery, Drugs, or Injections (available on Amazon)
• SoftWave TRT providers: https://softwavetrt.com

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Transcript

Most patients, I would say 90% have no idea that if they inject cortisone into their joint. There's a really strong likelihood that that could degenerate the joint or degenerate the tendon or degenerate other structures there.  and patients still might choose to do that because maybe they're going on vacation in, in two days and need to have something for that short-term relief, but give us the, information that's accurate for us to make, an informed choice.  

Welcome back, my friends, my dear listeners. Hey, if you're new to this podcast, thank you for finding me. Welcome, and if you're a returning listener, I'm so glad to have you back. It has been so hard for me to record, edit, and publish a podcast episode and do all the artwork. 

Yes, I'm a one woman show here at the Menopause Disruptor Podcast Head office, which is my sunroom. if you haven't listened to my last podcast, I share my story about incurring a mild concussion and just the nervous system regulation getting back into daily life again. It's been really hard, lots of pain, headaches, vertigo, and just this feeling of

not being myself, but here I am. It was important for me to get back to this one true passion that I love so much. And share with you 

the advice, guidance, and stories of experts in the field of women's menopausal health. 

it's so apropos that my next guest is here to talk about pain. pain is one of those things that we could spend a lifetime trying to work on. 

Millions of people suffer from joint and muscle pain every day enduring countless treatments, even surgeries and medications that don't seem to offer lasting relief or sometimes any relief at all. My next guest is here to talk about the pain-free formula.

I'm so excited to present to you. A pain specialist, physical therapist, registered nurse and healthcare expert, Stacey Roberts, she will share a revolutionary, holistic approach to eliminating pain, especially joint pain Without relying on surgery, drugs, or injections, and she shares her personal story about battling the system to get pain relief, and this is why she's taken a journey into pain management.

 Stacey Roberts is so experienced in this area that she wrote a book about it called the Pain-Free Formula. Solving the puzzle of muscle and joint pain without surgery, drugs, or injections. Stacey has over 30 years of experience in physical therapy and functional medicine and has empowered thousands to overcome suffering from chronic pain.

She has been a guest on numerous television shows throughout the United States and Australia, and the host of the Pain-Free Podcast. She also happens to be the first physical therapist clinic, which is located in Wauwatosa Wisconsin to purchase the soft wave. for relieving pain, which she will explain to us in this episode.

Her clinic, the New You Health and Wellness Practice combines cutting edge technology, advanced manual therapy, and functional medicine to help patients obtain optimal health. She will also address Pelvic Floor Pain. And how this shockwave or soft wave technology can actually help women with pelvic floor issues including incontinence, painful sex,

which is a common, problem that affects so many women in their menopausal transition. Please join me in welcoming Stacey Roberts to the Menopause Disruptor Podcast. Stacey Roberts, welcome Delighted to have you here and to talk about pain-free living.

Fantastic. Thank you so much for having me. Mm-hmm.

Alright. Your line of work how you can help clients live a fulfilling life. Without pain. 

But before we get into that, tell us a little bit about your journey into the wellness profession.

Sure. So I've been a PT for over three decades, and then recently, in the last five years, became a nurse to kind of increase my scope of practice.

Mm-hmm.

I've been treating pain since, the nineties, uh, when I graduated in 1990. And what I always, what always kind made me question was, what, why aren't some people getting better now?

It's really easy for. Me to say they're not doing their exercises, they're not being compliant with what they're supposed to do, blah, blah, blah. But there were patients that I had that I knew were doing what they were supposed to do, and I knew what I was doing was supposed to be effective and, and they weren't getting better or they weren't getting better as fast as they should be.

So over the years I just started. First, it was kind of looking into how the brain and, and pain relate to each other, um, and how the brain changes when you have things like chronic pain. And then as I went through my own changes and transitions in life, you know, through menopause and post menopause, um.

I Found out that the significant impact that hormones have on helping us, deal with our pain and inflammation. And then gut and food sensitivities were really a big one for me. because when I got control of those things, a significant amount of the pain that I had in my, in my body went away.

So. I guess it was a journey, you know, to kind of first figure out why aren't my patients getting better and then why aren't I getting better, you know, uh, with what I should be from a structural point of view. And then it just helped to branch out more into a wellness kind of holistic view of it.

No pun intended, but it's our pain points that put us on this trajectory, our

Absolutely.

which we can find our transformation.

Mm-hmm. Absolutely. It happens to so many of us in, in the profession. For sure.

So through your journey, you discovered, a philosophy behind the pain-free formula. So much. So you wrote a book. So tell us what makes this approach to pain-free living a little bit differently, what's in that formula?

Thank you for asking. 

Yeah, so the pain-free formula kinda was born out of an injury that I had, at a wedding. anybody over 50 should, have to sign a release. For most weddings to say that they're kind of dangerous, so be careful. and I was on the dance floor with my son and he was trying to do the polka and I'm from the Midwest.

If you can't do the polka, it's kind of rite a passage. You gotta do it right. So I was trying to teach him how to do it well, and all of a sudden my knee just popped like it was an audible pop and. Searing pain, like somebody stuck a knife in it. And you know, my son probably, I don't know if he is seen me cry, but at that point the, you know, tear was running down my cheek 'cause I couldn't even put my weight on it.

He was holding me up and I kinda shushed him away and said, go back and have fun with your friends. And I kind of drugged myself. To a chair and I looked, my skirt kind of hiked up, my dress hiked up a little bit and I just, my knee was twice the size as the other knee, like within a few minutes.

So I knew that I did something. and being a physical therapist, I'm like, okay, I need to get some ice on here. So I left, went to the hotel. I wish I had a video watching myself try to get out of there without, you know, put much weight on it in a dress as like a six foot, turquoise. Flamingo or something walking outta there, on one foot.

and then I, I have a device called Soft Wave and that really brings down inflammation significantly. So after three treatments of that, um, I was off my crutches and walking not quite normally. My knee was a little bit unstable, so I decided to go to a doctor and said, what was the pop I could, I could take care of it.

I could rehab myself. That was not a problem, but I was really curious what the heck that pop was. 'cause it wasn't, I didn't have any pain in that knee until I had knee surgery on it in like 1986. So what was that like, you know, 35 years ago at the time? So I sat down with this doctor I thought would be a great, orthopaedic surgeon, I thought would be a great conversation with a colleague and discuss, my knee and, possibly what I do in my clinic and things like that.

And she put up x-rays onto the computer screen and said. Basically, well. You know, you're gonna need a knee replacement. And I was like, wait, what? I didn't have any pain prior to that. And she just kind of went in barely touched me, you know, moved my knee a little bit and then, told me this.

And I was like, I just wanted to know what that pop was. I haven't had pain in that knee. Forever, and what it was a blessing in that moment was for me to look at my x-ray and see the extensive arthritis and think to myself, that didn't happen at the wedding, right? That's been going on for a while. So that made me realize you can have significant arthritis and not have pain.

So that was number one. That was really good experience for me there. 

And then she was saying, okay, I understand you don't want surgery. The only thing I can offer you then is a cortisone injection. I just said, no thank you. And she asked, do you mind if I ask why? And I thought to myself, man, I'm really trying to be a patient, right?

I'm trying not to be a provider or therapist in this moment. Uh, but she asked, so I said, okay, you know, well the research shows that cortisone injections actually degenerate the joint more. You get more, degeneration and, and I pointed to the x-ray, why would I wanna put that in that knee to accelerate the degeneration of it?

Why would I wanna do that? That just makes me a definite customer for her in as far as a knee replacement goes in the future. So She said to me, oh, you'd have to have a hundred of those cortisone injections in order for that to happen. Then I've got. almost angry. I mean, I felt the heat kind of rising up into my head because I was like, that is so untrue.

How many other people have you said that to? Or the hundreds of other orthopaedic surgeons that believe that have said that to around the country, and it was really then. I decided I have to get this information out to more than just the people that I see, and that's how the Pain-Free Formula was born. I just put together all the holistic things that we do in our clinic, and put that together for other people to understand.

Explaining how conventional medicine usually treats pain and sometimes it works, but a lot of times it, it's not enough and that what are the alternatives when it doesn't work for you, or what's that alternative if you don't wanna go down the. Injection route, the medicine route, or a surgical route.

We all understood, cortisone injection all the time.

Mm-hmm.

You got a pain,

Yep.

your joint injected with the cortisone.

Mm-hmm.

obviously this is well researched, reviewed

Mm-hmm.

on this. Why isn't mainstream media in the medical community. I just like menopause, talking about this.

Ex. Exactly. You've really just said it there. It's much like menopause. I mean, from the standpoint of, I'll ask doctors this. I'll ask doctors who I learn this stuff from, and I'll say to them, why are you still doing cortisone injections? Patients want it and it's cheap and insurance pays for it.

That's really the bottom line. So my thing is, okay. Let's have some sort of informed consent where you're actually telling the patient that this is what is likely going to happen. This is the research. Everything I do has to have informed consent so the patients know what should be happening or alternatives to it.

They should have that. Most patients, I would say 90% have no idea that if they inject cortisone into their joint. There's a really strong likelihood that that could degenerate the joint or degenerate the tendon or degenerate other structures there. and patients still might choose to do that because maybe they're going on vacation in, in two days and need to have something for that short-term relief, but give us the, information that's accurate for us to make, an informed choice.

Absolutely. Knowledge is power this led you on the journey to

Yes,

Tell us

exactly.

to bring this knowledge to mainstream where you met with some challenges that you were, you were challenging the status quo when it comes to pain,

You know? The interesting thing is I've always, everything that's in the pain-free formula is something that I've been talking about for over a decade, and when I first started talking about it, especially here in the Midwest, people would kinda fold their arms over their chest and lean back in their chair.

And they didn't really wanna hear it, right? They didn't wanna hear about their gut and, food. And, nobody kinda understood the hormone connection at that point in time. And they just came to me 'cause they wanted something different. They, you know, wanted physical therapy or something different than what they've had before.

'cause what they had before, it didn't work. But the interesting thing, Mary, in the last, I don't know, probably five to six years and, another reason why I felt like this is a good time to write the pain-free formula is they start leaning in now when I talk to them about things. they want more information about their diet. some of them may not be ready to, to change their eating plan a hundred percent or, get rid of a couple of the food sensitivities that, their, you know, favorite foods, foods are their go-to foods, but they are interested.

So people are starting to. Understand these connections and when that happens in the Midwest, I know it's happening all over the country 'cause we're usually the last ones that kind of make that leap. so I think doing that and learning so much through writing, it took me two years to write it.

 and learning so much about much that I didn't know about NSAIDs and other pain meds and how those really actually slow down healing instead of help us with healing. And so many things that I learned through it has just made me. A better therapist and again, being able to give my patients good information that they can make the best decisions on. 

Practice when it comes to what the root cause of pain is. We've heard it. Dr. Tim Spector, the gut health doctor, you alluded to that too. Our gut sensitivities, the gut brain access, how they communicate is the root cause inflammation.

Sometimes, so chronic pain, sometimes people have, inflammation and that will absolutely be the root cause and that's something that with the software device that we have, we can get rid of that localized inflammation or modulate it, give the body what it needs to to heal itself in the area. But, oftentimes there's a systemic issue, right, that has systemic inflammation that could be contributing to that localized inflammation.

There are some studies though, of patients with chronic pain where they look at it and there's no inflammation in the joint. They don't see anything wrong with the area, and many times that is then a signal that the brain activity has changed in regards to the pain. We become more, the brain becomes more protective of us.

I want you to feel pain if you're near a fire and you know you're getting too close, right? I want you to feel that so you move away. But when that process in our brain, overworks or over protects us, uh, it's called, uh, central sensitization where we be, we become very hypersensitive to pain. Um, sometimes it's not related to inflammation and it's just related to our.

A pattern that our body's gotten into to protect us and, um, change. We can change those patterns in the brain though through something called neuroplasticity. Um, if we continue to focus on moving, you know, movement is medicine. So if we continue to focusing on movement in a way that we are not instigating that pain and that our body starts to trust us and we start to become one with our body again, there are many ways.

To kind of desensitize ourselves to feeling that pain.

Right. So, so that's when we really wanted to say, what can I do?

How can I listen to my body? What's my body trying to tell me? So it doesn't get to the point where I'm debilitated or I can't pick up my grandkids. I can't do pickleball. I can't go on a hike with my, you know, my significant other or whomever. so we wanna try to head it off at the pass before it gets bad.

So how much of a role does female hormones and in particular estrogen or estradiol E two have when it comes to buffering brain sensitivity or hypersensitivity to pain?

So if estradiol. E two is too high. It can make you hypersensitive to pain. Uh, when it comes too low. What people, a lot of people don't understand is estradiol, testosterone. Cortisol, even progesterone to an extent, are anti-inflammatory molecules in our body. So they help us fight inflammation. So if estradiol itself is too high, maybe somebody has a history of endometriosis, fibroids, things like that, or it's not opposed with a balanced amount of.

Progesterone so it doesn't necessarily have to be too high, but it doesn't have progesterone to buffer it. Then that could contribute to pain and hypersensitivity. When it goes down to low, both estrogen and progesterone go down to low. We lose the protection against inflammation that could be contributing to pain, so inflammation can start to bubble up to the surface that we didn't feel before.

I've had so many women say to me, what I eat well, or I've eaten this way for, you know, all my life, or 20 years. Well, our body's not the same as it was when we ate that way before, so we might've been able to get away with it, right? Because we had this built in anti-inflammatory, natural anti-inflammatory molecules in our system.

 we've lost that in through perimenopause and menopause. And that's why that, pain, joint pain joint and muscle pain is almost as. Common, if not more common at times than hot flashes. We don't often talk about that. Pain is related to menopause, but we certainly do talk a lot about hot flashes.

And yet, joint pain is one of the most, remarked as one of the highest

Mm-hmm.

that women will. Experience in menopause is the joint pain.

Exactly.

so, and, and that is one of the reasons why that pain is so debilitating that they don't want to exercise, they don't wanna move because it hurts the joints.

But movement is medicine. So how do you work around that? And I think I like to talk about it again in context to that gut, joint

Mm-hmm.

and exactly what is happening with our gut microbiome

Mm-hmm.

joint pain.

Absolutely. Well, how we work around it. First, most people that come to me, are coming because they, want, uh, us to utilize our software device. But I also then look at taking the trigger away. So something, if there's inflammation still in pain. Something continues to trigger it.

A lot of times it's the way we move after we've been injured. We start to compensate in certain ways. So we work on movement within the range. That's not painful. A lot of people think, uh, no pain, no gain, or they're seeing a trainer that's like push, push, push through it. Well, there's certain types of discomfort you can push through and certain types of discomfort that's going to make you worse.

I get a handful of patients every month. That say I went to physical therapy and it made me worse. They made me do these exercises and I told them it was making me hurt more and they said, you just gotta push through it. That's unfortunate because there's certain types of pain you don't push through.

That's where that physical therapist should be educating that patient and Okay. Does that feel like the muscle is stressed or is it actual pain in the joint? It's pain in the joint. We're recreating why they came in. Absolutely not. You shouldn't be pushing through that. So we, we move them through a range that's not painful to get their body used to moving again and to build up their confidence that they can move without pain, even if it's a small little bit of movement.

And then gradually we get them stronger or more flexible or more stable in order to expand that movement. And if they're not getting better for, for me, after the third or fourth treatment, they should be at least 50% better. And if they're not, then we start looking for the other things, like we talked about hormones a second ago.

But to your point, the gut joint axis is, is something that's completely overlooked. And how that works is, you know, our gut's like a tube. And that tube is insulated by a single layer of cells. And in between each of those cells there's something called a tight junction. So that tight junction, if you imagine a, a picket fence.

And in between the slats of the picket fence, if you put some glue in there. That would be like the tight junction. So the tight junction's in between those two slots. If that tight junction becomes leaky or weak or increased permeability is what, um, the medical term is.

Then stuff from the gut can start to leach into the body, and that's how food sensitivities can happen. If too much of that gets into the system, the body. Anytime something shouldn't be in the system that gets in the body attacks, it creates some inflammation. So anytime we even, we eat, we have inflammation, right?

So we're not getting, I don't wanna get rid of all inflammation 'cause inflammation's part of healing, but I wanna keep it at bay and keep the body being able to manage it. but if all of a sudden I'm eating things, several things a day, every single day, 52 weeks outta the year that are contributing to significant inflammation.

We can have sensitivities to that, and that can end up being, a common cause of joint pain. One particular molecule that can get into that kind of now leaky, uh, or weaker tight junction, something called lipopolysaccharides. So lipopolysaccharides are considered endotoxins. They're, they connect to, um, a bacteria and then get.

Into the system. Um, the body tries to contain 'em as best as possible, but if too much is in the system, then they can migrate to the brain. Uh, they can migrate to joints, they can migrate to muscles, they can migrate really anywhere. And when they look at things like osteoarthritis, they, us usually see a significantly increased amount of lipopolysaccharides.

So we used to think that osteoarthritis was just wear and tear. Now we know that there's much more to it that actually our gut, which could be influencing whether that. Tissue and cartilage and bone is breaking down due to inflammatory markers coming in from the gut and settling in the joint. And oftentimes it'll settle in a joint that has already been injured or previously injured before or have had surgery because that kind of, uh, vacuum capsule that that area that's been protective all our lives never really been exposed to anything outside of it, has now been exposed.

So it's almost like it just zeroes in on those areas that have been, uh, an issue for us over. Over the years. So by shoring up that tight junction, by improving your microbiome so that the microbiome need food, right? Just like we need food, our microbes and our gut need food, and if they don't have the kind of food that they need, they will eat away at that tight junction.

And that's one of the ways it becomes. Leaky. So by getting more diversity in our diet, by eating the things that we know that we're supposed to be eating, and, you know, fruits and vegetables and, diverse types of foods and staying away from ultra processed foods that those microbes don't want, will oftentimes, significantly improve the health of those tight junctions and minimize the amount of that LPS or lipopolysaccharides that's leaching into our system.

Wow. The lipopolysaccharides. I'm gonna guess saccharides. Is it? Is it the sugars?

It's, it is a type of sugar but not the sugar that we think of it from the standpoint of like sugar that we're eating. Uh, lipos fat and saccharide is type of sugar, but it, it connects to a gram-negative bacteria and piggy's backs its way into the system. And those gram-negative bacterias can often time, be much more inflammatory for our system.

I've heard it before and you alluded to it, the gut microbiome

Mm-hmm.

color, 

Loves that diversity.

The diversity of all the colors of the rainbow

Exactly.

of the, the first protocols when you're addressing a pain-free living for your clients and patients.

I always try to meet my patient where they are. So if they're not ready to really look at that, and if they've come to me for a certain specific reason, maybe they've come to get, just get soft wave. Maybe they've come to, to talk to me about, their food or maybe their hormones and then we introduce these other.

Aspects of what could potentially be contributing to their pain. Because I'll always look at the thing that's more common or obvious for that person sitting in front of me. If somebody comes in, they're 45 years old, the pain's moving around their body. One, you know, one week it's in their shoulder the next week, it's in their hip or foot.

I'm thinking probably more hormones if they've never had that type of pain before. If a woman comes to me or a man comes to me and every time they go to bed at night, they have an ache in their hip. For their, you know, whatever joint it is. Um, then we talk about, uh, what do you typically have for dinner?

So we see if there's something that might be contributing to their issues at nighttime that possibly they're eating during dinnertime. So everybody, depending on how they present to me, I meet them where they're at. not everybody gets the same recommendations. everybody's body's different, so we really personalize their situation here.

Uh, the vast majority of people do come to me though from because of my physical therapy background. So that's their expectation there first. So we usually start. First there, in those bowel mechanics, how are you moving? How can we improve your movement? Um, and take the stress off of that. Remove the structural trigger.

I call them tangible triggers in, in the pain-free formula of the book. Uh, but then we are gonna look for some intangible triggers, the ones that we can't easily see or measure. and those are the hormone changes, the gut issues, the potential issues with, you know, pain in the brain.

what other modalities, are available to your patients so that they can, mitigate. The need for surgery and medications.

So here's the interesting thing. 

I never used any modalities until I came across Soft Wave, which is a type of shockwave device. And I even when that came across it, I didn't believe it would do anything 'cause I hadn't heard of it and I'd been a PT for at that time. You know, still 30 years. It was just, into my third decade of being a pt.

So I was extremely skeptical. Usually it just took my hands and instruction to the patient and, you know, certain movement and those, that type of things 'cause other modalities. You know, they might work a little bit, but they didn't really move the needle for the patient. But then when a friend of mine came to me and said, Hey, what do you think about this, uh, thing called Soft Wave, which is an electro hydraulic shockwave device?

Um, I said, ah, it's probably not gonna work. And she said, will you just come with me to this appointment? And she got the guide to actually come down to Milwaukee. It was about an hour and and a half away, and I begrudgingly went. Is there gonna be lunch there? You know? Okay. Because that's what we're used to in the medical profession is medical device.

People come in, bring the lunch, I go for the free lunch. I say, okay, yeah, that's interesting. And then see you later. and in this case, we went to my friend's house. He did a, a demonstration and I was. Floored. She usually had pain in her shoulder when she'd move it in a weird way or sleep on it in a weird way, like pick a ball way behind her or, you know, slept on it very strangely.

That's the only time she had pain. I'd worked with her in pretty much every body part of hers over 40 years and we got the shoulder, issue to be resolved except for those couple movements. So she sat down in the chair, they put the soft wave on her, shoulder, and he didn't know that she had calcific tendonitis in a very particular spot in her shoulder when the device went over that area, she goes, well.

Well, wait a minute. That's, that's the pain that I normally have. Now, if you're a physical therapist listening or if you know anything about the body, that's very indicative, that's indicative of something very unique. Her hand was down by her side. It wasn't in the position where she would normally have pain, but somehow that wave as it penetrated, the system bounced off the inflammation or the calcific, calcified area of the tendon and sent a signal to her brain to say, Hey.

Something's going on down here, you know, check in. And that's where we go, Ooh, that's pain. Right? And if it's the pain that we typically feel, that is very relevant. So after the treatment, she raised her arm up and she moved it. 

And, you know, I had kind of been leaning in after I saw that happen. And, she said.

Wow, it's gone. And I go, okay, well, it'll be back in a couple days. And serendipitously, most of the time the first treatment lasts for maybe a couple days, uh, maybe even a couple hours. But hers lasted for two years. we call it a one and done. I've only had that less than a handful of times in six years.

So I really believe I was meant to be in that spot, see her being treated, because otherwise I would never have believed, what it accomplished for her. And that's, I was the first physical therapist that, purchased a soft wave device in the US and I haven't looked back. now going on six years ago.

That's incredible. 

What does, I'm, I'm intrigued. You said you leaned in. I'm leaning in

Yeah.

computer screen here. Tell me more. So what does this device look like? Is it. It a, is it a wand?

Yep. It has a wand. So I thought it was like a glorified ultrasound that had this flashing light. I was like, really That can't do anything. It has a clicking sound as well too, but what happens is there's a little electrode inside of it, which creates a spark and the water inside of it as well allows that spark or shockwave it's called to travel through that water at the, uh, speed of sound and goes.

Into the body and changes into an acoustic wave. So if you imagine yourself standing on the beach and the waves are going back and forth over your legs, that's what's happening inside the body. And your legs are, let's say cells. So that wave is hitting those cells and the cells then contract and expand 

Because of something called cavitation, which is little bubbles that are created around them that stimulates the lymphatic system. So the swelling almost goes down immediately, but it also stimulates the rest of the body to send those healing molecules, molecules that are anti-inflammatory, uh, moving them from a pro-inflammatory phase to an anti-inflammatory phase so the body can heal, moving, um, different other factors in there to increase blood flow.

 there's a, a list of different molecules that go to the area stem cells. We see the progenitor cells there, so we know that stem cells are traveling to the area and they have a huge impact on healing. So, and it does it in such a way that makes an impact right away, and we get a regenerative impact.

Three months later. 

So a lot of my patients will be done with their treatments in four to six weeks and then continue like once a month for a couple months. And then they, they're like, I don't, I don't know what else to treat. I feel really good. Um, after they've done that few little bit of maintenance.

So then we just treat 'em like professional athletes. Then we just go over the area, we map it, see if there's any problems that we can prevent, right? That are potentially brewing in, in that particular area or another joint. What can we do to prevent that? Here's some exercises so you don't get hurt. doing what you love to do and then keep them fit and healthy and pain free for as long as possible, and as active as possible.

incredible. So many questions are coming out of this one.

Good. Mm-hmm.

of all, when it comes back to aging and menopause, andropause for men, let's face it. 'cause they go through a similar situation with, with losing testosterone. And as we get older, and it's always been, stated that, pain. It's related to aging. You're just getting older. This is the fact of life. you're not responding to the hormones anymore, et cetera, 

Mm-hmm.

thinking, you know, you're treating one area with the soft wave And that's healed, it's a testament to your patients that this works. are they coming back saying, you know you've healed my shoulder. We've worked on that. I've got other areas now like the knees, the hips, which are classic

Mm-hmm.

get pain.

Mm-hmm.

floor for women

Mm-hmm.

like to talk about too. So quite feasibly they'll come back They're convinced, yes, this is working and do they return for like almost a whole body treatment.

 absolutely. So once we explain, it's really interesting 'cause if I'll treat somebody's shoulder and then they'll maybe come back for those maintenance sessions and they're like, yeah, I went to someplace else for my hip pain and I was like, you, you know, that soft wave can treat your hip pain. Right?

 And I needed to do a better job of like putting stuff up in my clinic to be like any joint, any muscle, you know, that type of thing. So yes, once they're educated and understand, because it gets them better, so much faster. I mean, I've been a PT for a long time. I don't like to say that I'm amazing or anything like that, but I, I got people better pretty

 much with pt, I know what I'm doing and it would take me, let's say plantar fasciitis, right? Let's, it would usually have taken me 10 to 12 treatments, and that's pretty darn good to get somebody back to what they would normally be doing with plantar fasciitis. When I add soft wave to what I normally do for plantar fasciitis, they're back in three to six treatments, so it really cuts it to.

Third to half of the number of treatments that you want. Some people are discouraged because it's cash, but when you look at the amount of time that you save, it's significant. It's the, it gets you better and back to what you love to do faster. And the more people that go to this, hopefully in some way, shape or form, it's gonna be covered by insurance some way.

But right now, They cover cortisone injection that tears your body down. But, at this point in time, uh, there's not, uh, coverage, on a regular basis with commercial insurances for shockwave. I'm hoping, uh, and the company that I work with, soft Wave is hoping to change that over time. But, you know, nothing goes fast when it comes to insurances, things like that.

So, so yes, people can be treated in different ways. We don't treat several areas of the body at one time because it can be overwhelming to the system 'cause we are up-regulating the body's. inflammatory process to move into more of a healing process. I'd like to treat one area the very first time that I see you, so that I know how you're gonna react to it.

And then after that, we can decide to add another area in maybe either after you're finished treating the one or the same time if you want to do, you know, two different body parts, that's an option too. So really again, we meet the patient where they are. We meet the, where they are in their pocketbook, as well as how they're presenting in the clinic.

So when it comes to pelvic floor pain,

Mm-hmm.

 one of those areas that is the most frustrating for so many women,

Mm-hmm.

it's vaginal atrophy, dryness, urinary incontinence, urgent leaking. And then even affecting their sexual intimacy.

Absolutely.

tell us a little bit more about the treatment.

And I'm, again, probably the soft wave treatment, what other lifestyle modalities, protocols that they can integrate into their everyday life to address pelvic floor pain.

So with pelvic floor pain, just like any other pain, because it is orthopaedic in nature, right? Still involves muscle, joints, bones, all that type of stuff. Um, but we don't really know that we have the muscles. And joints there, right? Or ligaments, you know, that are helping us, right? so if it's pelvic floor pain, we gotta find the trigger.

We gotta find the cause. Where is it coming from? So no matter how good soft wave is, if I'm aiming it in the wrong spots, it's not really gonna help. So we've gotta figure out what the trigger is and then we, we treat the pelvic floor either manually, or, and through functional exercises. So what software does really well, that helps with pelvic floor is a lot of times pelvic floors can be upregulated, which means there's.

More tone. Some people call it tension in that pelvic floor and the muscles aren't releasing, right? So what happens with soft wave is it brings blood flow to the area immediately. Like, uh, areas where I've palpated that was either very painful for the patient or felt like a rock. Now our soft like butter, so I can do more manual therapy.

I can release those muscles more easily and therefore the pain can then decrease as well too, or be eliminated completely. We look at then how the nerves from that come out from the spine, how they innervate into the pelvic. Floor and innervate into the genitals. 

the pain is a little bit different than treating something like vaginal atrophy or vaginal dryness, or even incontinence.

Um, so with those things it's a little bit different. The blood flow significantly helps plump up the area. You'll see the labia that were, that a woman who's on the pill for many years kind of look, you know. Sad, like they haven't had much activity for in forever. And you'll see them puff up, perk up, things like that with that significantly increased blood flow.

If you combine that with hormone therapy, it's a fantastic combination for keeping the woman, in a situation where the dryness isn't there anymore. the comfort is back with intercourse and the pleasure is back as well too. when you have both of those modalities together.

when you say, hormone therapy the vaginal cream 

It depends on the age. many times just estrogen cream will be fine. Uh, it depends on the issue. Sometimes, um, patients will be taking, have their estrogen patch, and take oral progesterone. That's a common combination. Some people can't stand the oral, they can't tolerate the oral progesterone, so then we, they might use vaginal progesterone as well too.

So there's different, everybody's a little bit different in how they present. 

But one thing you did ask me that I wanted to get back to is, what can somebody do at home? Right. What can somebody do at home? One of the biggest things, which is sounds so simple, it costs absolutely nothing and you and I are doing it like every, you know, few seconds anyway, right now is breathing and understanding how diaphragmatic breathing, which is breathing kind of from the belly and expanding that actually stimulates the parasympathetic nervous system, which is the system that helps us rest and digest, stimulates that vagal vagus nerve in order to,

To help down-regulate that pelvic floor. Remember I called it upregulated pelvic floor, where everything was a little bit, extra tone or extra tension, however you'd like to describe it, when we can kind of reconnect with that area of our body and really breathe through. And I work a lot with men on this as well too, for their pelvic floor.

Um, and to be able to release that and let that pelvic floor just do the job that it's supposed to do because my bicep was contracted all the time or didn't wanna, and didn't wanna strength, straighten it all. That would be pretty hard for me to utilize that muscle. Right? So it's the same concept with the pelvic floor.

If it's not in a state where it can do what it's supposed to do, then there can be issues that surround that as a result, and it can manifest itself as Pelvic pain, incontinence, urgency, you name it, dyspareunia. We did a, I was a principal investigator in a study on dyspareunia utilizing Sham, shockwave and PT and our device Soft Wave and pt, and we saw that with soft wave.

In addition to pt. The PT alone, they got better because we were using some of the top. PTs around the country who do pelvic floor, but when we added soft wave to that, what we saw is the tissue extensibility was significantly improved and that showed us that they were able to, tolerate intercourse without pain more easily.

Mm-hmm.

in in leaks, and,

it's, it's really, I couldn't wrap my head around how it worked with incontinence and leaking. At first, nobody really was able to explain it to me until I ran across a study that explained it. And when, as this is one thing that happens as we age with our lower hormone levels. It's not necessarily because of aging, but as we age and we decrease the hormone levels, we lose blood flow to those tissues of the urethra and the, uh, the muscle, the detrusor muscle, and the bladder.

So what soft wave will do is bring blood flow to those areas. And kind of nourish those tissues, those muscles and the mucus changes that increases and those muscles start working the way that they should. It's not that they necessarily got stronger, it's just that they actually had the nutrition to do what they're supposed to do.

Then you add that with other functional exercise that we do to, to make them stronger and incontinence it, whether you're 20 or. 85. We're using this in conjunction with pelvic pt, uh, using soft wave in conjunction with pelvic pt. It's one, two, or three treatments and they're pretty much done with it. It's unbelievable how fast it works for that.

Mm-hmm.

I'm gonna presume though, that we, you're using the soft wave device for pelvic floor health. It's still external to the body 

Correct. 

The reason why it's so it works so well is because our device, the particular thing about soft wave is that it can penetrate deep, but it also can penetrate wide. Most of the other soft wave, or excuse me, shockwave devices come to a certain point 'cause they used to be used to break up kidney stones at a much, much higher level.

These are low intensity, but they didn't change it from being a pinpoint in those other devices except for soft wave. It creates more of a broad focus, right? So we're, we're focusing on a larger area, so an area that's the size of maybe a quarter versus the size of a point of a pen. So we cover more area faster and more comfortably because everything's not concentrated in this one small space.

It's concentrated in a larger focal zone. That helps us, um, you know. Have the patient have more comfort, but also bring more blood flow to more tissue. and you'll always see that with our device, there's less shocks and it's a, more comfortable, uh, experience for the patient as well too.

 Okay, I wanna fly down to Wisconsin right now. I

Right.

 With

Well.

I'll give you the link to where you can find a provider in your area on the soft wave website, soft wave, TRT, like T as in Tom, R as in Robert, T as in tom.com. There's a provider search up at the top. So if you put in your zip code, you can see who the software providers are in the area.

Not all of them will be trained to do pelvic health, but every one of them will be trained to do any type of joint or muscle issue.

Mm-hmm.

We'll get those links in the show notes. This has been incredible information. 

your journey with writing your book, and in the six years that, you've brought this device into your clinic, how have you seen the medical community or shift, if at all, towards pain management and pain treatments? 

In my area. there's been a, a slight shift 'cause now there's eight practitioners around me that have the device. So, but those are usually the practitioners that were thinking outta the box in the first place right now. So it wasn't really, stunning to those patients, but what I see happening around the country.

Because I do a lot of training, uh, with, uh, providers around the country is more people are starting to, like, I was lean in a little bit, say, really this does work. Like I see that there's research behind it. I see that there is some information, my patients are coming to me asking for it. 

So I do think it's making a, a dent outside of people who would Typically use it, like typically be used to modalities, be used to something else that's outside of mainstream, starting to make a change. If it were covered by insurance, it would be all over the place. I mean, that's when, hospitals would invest in it, things like that.

But right now, it just really started to trend and, and understanding. It really started in about 20 20, 20 21. so there hasn't been a huge, Dent in more of the conventional medicine, point of view. and that's all unfortunately in our broken system, is ruled by insurance, which doesn't have 

 have us in mind in regards to outcomes. It has, what's best for making the money, which, is unfortunate. But we, the fortunate thing is we do have choices beyond that, that system.

Yes, we do. And you've alluded to some already. one of them I wanted to ask about before we move on to some rapid fire questions. 

And that is, and I'm, I love that you mentioned breathing, diaphragmatic breathing and a lot of breathing. We think breath work. We also think mindfulness and meditation.

How much of a role does that play, that mindset play into also addressing pain and managing our pain?

It's really interesting that you asked that question. 'cause a very good friend of mine that sees me, has a, a significant amount of pain. We're trying to figure out from a hormone point of view what we can do. 'cause she's doing everything else that she should be doing. But we had this topic of conversation where I said, so when you have the pain that, that you're experiencing, what are your first thoughts?

And she's like, what do you mean? I'm like, you know, what do you first think about like when the pain comes back? She's like, well, I think about, oh my God, why is this happening to me? And, and we go down that path of catastrophizing and, you know, um, but I said to her, I said, but you know that the pain at some point goes away, right?

She's like, yeah. We know that if we, if we continue going down the catastrophizing route, we're creating more molecules, more, um, you know, inflammation if you will, in our system that's worsening the pain that we have, making us more hypersensitive to it. So we really do have to stop and say, it's not about positive thinking, it's really about constructive thinking and going, you know what?

I have this pain now, but you know, I know it's going to go away. and, you know, kind of see ourselves not having pain. 'cause sometimes I'll ask. Are my patients. Can you see yourself in the future doing what you do now that causes you pain? Doing that without pain and someone who's had chronic pain will struggle to really create that in their mind, mind's eye, and see themselves in the future doing that when they've had chronic pain for a while or they tend to have more of, maybe a history of anxiety or those types of things.

I'll say, can you think of. When you didn't have this pain. And it'll be very difficult for them to come up with a memory, even though consciously they know they didn't have the pain. It'll be very difficult for them to come up with a memory and even thinking in back then, or if thinking in the future of moving in that certain way, they're sitting still and they have the pain, so the pain happens.

So that's where The brain changes, right when we are kinda reinforcing those patterns that can contribute to more inflammation, more central sensitization, more hypersensitivity. So just sometimes just even understanding that and then working with the patient to say, okay, let's think about.

Three months in the future, you're picking up your grandchild and you feel great, and then you getting themselves to really be able to visualize that, hear what they're gonna hear when that happens, see what they're gonna see, feel what they're gonna feel will break that pattern and start exercising those other patterns in, in the brain.

Those other pathways, I should say, neural pathways in the brain through neuroplasticity, because we know that we have neuroplasticity of our brain. For, you know, well into our, you know, geriatric years that we can change those patterns and help us, help ourselves heal. It doesn't magically make it go away, but certainly can help us heal and decrease the amount of pain that we have.

It's beautiful. Yes. I love, how you phrase that, the neuroplasticity.

Mm-hmm.

It's really rewiring the brain, the neural circuitry

Mm-hmm.

these positive, or not necessarily positive as you say, but constructive thinking whereby we recognize that our job is to reduce that hyperactivity of the brain, the hypersensitivity of the brain, 

Yeah. And brain's just trying to protect us. it's just doing it too well, too well, and we want it to, shift. And it's kinda like, it's stuck in a rut, right? and we wanna try to get it onto a different pathway, not going down that same rut of that one pathway.

Well this has been amazing let's tell our listeners where they can find you, where they can find your book, and we'll close with some fun little questions.

Awesome. So the pain-free formula, solving the puzzle of muscle and joint pain without surgery, drugs, or injections is on Amazon you can find it there, you can call our clinic. We can send one to you if you prefer to purchase it direct from us. the audible recording of that will be coming out 

Later in this year, the name of our, clinic is new, N-E-W-Y-O-U, new U Health and Wellness. And the website is that all spelled out, N-E-W-Y-O-U health and wellness.com. So you can reach out there or email us from there and we can see how we can help you. We do some telehealth coaching as well as if you're in our area, we can help you with you coming into Soft Wave and, and I'll get you that information in the show notes for people who are looking for the soft wave treatment.

 We'll get all those links in the show notes. So let's finish it off with some insightful information from Stacey Roberts about

Sounds great.

What's the biggest lie you've ever been told about aging and pain?

Oh gosh. it's inevitable, right? So I always say that pain doesn't have to be a life sentence. aging doesn't necessarily mean you're going to have pain that's gonna debilitate you and not allow you to be active in your life.

What does aging gracefully actually look like to you?

To me, aging gracefully means being able to. Happily spend time with friends and family or people that I love, in a way that's as active as possible, and I can experience as much of life as possible while doing that.

Beautiful. What are people getting wrong about mobility as they age?

I think we alluded to that earlier is that if it hurts, we have to push through it. And then if it hurts too much and we don't wanna push through it, that we shouldn't move at all. So we've gotta find a way that we can move within our, our limits, uh, without pain and then gradually expand that so that our world around us doesn't keep getting smaller and smaller and smaller.

Yeah. is one habit that makes the biggest difference long term?

Uh, definitely breathing, diaphragmatic breathing, getting really understanding how to stimulate that vagus nerve into that parasympathetic nervous system. And then I would say the second one would be your mindset and what you're focusing on every day.

Oh, that's beautiful. That probably answers the next question,

Okay.

here we go. If you had to boil it down, what are your top three strategies for living Pain-free at any age?

Could keep moving. So whether that's, you know, within a certain limit that you, that you have, that you're able to do that without. Exacerbating the pain. keep breathing, right? We all have to do that anyway, so might as well try to improve that breathing, process so that we are moving ourselves today.

We're so stressed all the time, so moving ourselves out of that stress, mode into more of a rest and digest where our body can recover. And then what I said before, you're absolutely right, that was my answer, is focus on what you can do about something instead of, what you can't do. So Keep looking, keep keeping your focus on where you want to be and not, or if you are exactly where you wanna be right now, focus on that, that that's where you are, instead of worrying about, oh gosh, is this gonna happen?

So a lot is mindset in regards to that. It's gotten me through almost 60 years, so I'm, I'm, I'm doing, doing okay.

Yeah. And here you are alive and well to tell the story with a book. That is fantastic.

Thank you.

This is a common topic amongst women that I see amongst my friends, those who come to see me strengths training. it's pain.

Mm-hmm.

 in all different areas, pelvic floor pain being one of them.

For

Mm-hmm.

the headaches

Mm-hmm.

a concussion. My last episode was about concussion. I am gonna take to heart what you shared today. This has been wonderful. Thank you so much for joining us, sharing us your expertise, your energy.

It's been a thrill. Enjoyed it.

Oh, thank you so much. It's been an absolute joy to be here. Really appreciate you. 

In my conversation with Stacey Roberts, we really pulled back the curtain on pain, what it is, what it isn't, and why so many women in midlife feel like their bodies are suddenly working against them. And one of the biggest takeaways is this, not all treatments are actually helping us.

We talked about cortisone injections, which are incredibly common, but what many women don't realize is that while they can temporarily reduce pain, they may also contribute to further tissue degeneration over time. And the real issue here is informed consent. There are still major gaps in how well patients actually understand what these treatments do, how they work, and what the long-term implications are.

Often, Patients make decisions based on partial information or what they've heard from others rather than clear, clinically guided education. And that needs to change because sometimes medicine isn't always helping. Sometimes it can actually be hindering the body's deeper healing process. We also explored how pain is not just physical, it's neurological.

The brain can become hypersensitive when pain has been present for a long time. It starts to interpret signals as dangerous even when there's no actual tissue damage. This is neuroplasticity at work, the brain trying to protect you, but it can create a pattern where pain continues long after the original cause is gone, and this is where movement becomes so powerful.

Movement when done in a way that's safe, feel safe and supportive. It's actually medicine. It helps retrain the brain. It tells your nervous system, you are safe here, and that begins to shift those pain patterns As Stacy Roberts talked about. And, We can't ignore the hormonal piece, especially in perimenopause.

Estrogen plays a key role in pain sensitivity. When it's too high relative to progesterone or when hormones begin to decline, we lose our natural anti-inflammatory protection. And this is why so many women start experiencing joint pain, stiffness, or new injuries in midlife. And it's not in your head, it's physiological.

And that brings us to inflammation. We talked about how pain, especially chronic pain, is often tied to inflammation in the body, and one of the most overlooked contributors is the gut. There's a strong gut joint connection when the gut lining becomes compromised. What many refer to as leaky gut endotoxins, like 

Lipopolysaccharides LPS can move into the bloodstream and contribute to inflammation in the joints and even in the brain. supporting your gut microbiome through a diverse nutrient dense diet full of color and variety isn't just about digestion.

It's about reducing systemic inflammation and supporting your entire body. We talked about osteoarthritis and how there's often more going on there than just wear and tear. There are inflammatory markers at play and understanding that opens up more possibilities for treatment and healing. And then there's the emotional and psychological side of pain.

 Pain has both tangible and intangible triggers. As Stacey Roberts. Explained our thoughts matter. If we catastrophize pain. If we fear it, we can actually amplify the inflammatory response in the body. but when we approach it mindfully with awareness even visualization, imagining movement without pain, we begin to rewire those neural pathways.

This is the power of the mind body connection. And then there's the power of emerging therapies like soft wave. In combination with physiotherapy, which can help improve tissue quality, increase blood flow, and support healing, especially when paired with functional strength training to rebuild muscle and resilience.

And this is particularly important for women with pelvic pain and pelvic floor weakness.

So, If you're interested in finding a software provider in your area, Visit soft wave trt.com 

 Simply click on Provider search. You'll find that on the top navigation bar to find a service provider in your area. I was partially joking when I said I'd jump on a plane down to Wisconsin and get some treatment from Stacy Roberts, but the truth is I don't have to go very far and neither do my friends who live in the Comox Valley.

We have shockwave providers right here One such clinic is exactly where I practice out of as a menopause doula, Origin Integrated Health. They use therapy. To stimulate healing in chronically irritated tissues, which is particularly effective for plantar fasciitis, tendinitis, calcific shoulder pain, and stubborn 

musculoskeletal conditions. You can check them out at originintegratedhealth.com. And of course, if you're in the Wisconsin area, visit Stacy Roberts at her clinic.

Newyouhealthandwellness.com. You can also find her book on Amazon, the Pain-Free Formula, solving the Puzzle of Muscle and Joint Pain without Surgery, drugs, or Injections. If you found something particularly interesting and helpful in this episode and feel that it could be most helpful to a friend, colleague, family member, please share.

And hey, if you're not following me already, , be sure to follow me on Apple Podcast, Spotify, or just about anywhere you listen to your favorite shows.