[00:00:00] Hi, good afternoon. Today I am with Jesh Patel, the owner of Brunswick Spine and Physical Therapy. I wanted to talk to him about some of the things he does and in general, his thoughts on fitness and his experience treating people with various physical ailments and to know a little bit about how he got here and what he has plans for the future.

[00:00:27] So, Esh, thank you for joining me today. Sure, sure. Kom. Glad to be here. And, uh, just to start off, can you tell me a little bit about yourself and, you know, what, what makes you who you are? Sure, sure. Yeah. So I’m, I’m Jack NH Patel. I’m a doctor of physical therapy and I’ve been practicing physical therapy for almost, uh, 18 years now.

[00:00:45] Wow. Um, mm-hmm. So, yeah, I guess when I was younger I always knew I wanted to do something in the science field. I was always, uh, attracted to that. Um, Okay. And I, I looked at a bunch of medical fields and I, I felt like I wanted to do something more active. So physical therapy seemed right for me. I volunteered at a few places in high school and I ended up enjoying it.

[00:01:06] Um, I, I opted not to go to med school ’cause I didn’t like the hospital settings. I liked more of the, the sports, you know, active settings. So, um, I stuck with it from high school till now and here we are. 20 years later. Wow. Time flies. Yeah, 20 years later goes by fast. Yeah. And in your role, um, ation, what do you do in terms of, you know, your everyday duties?

[00:01:27] So there’s different types of physical therapists. I happen to be an out outpatient orthopedic physical therapy. So whenever somebody has general orthopedic pain, whether it’s neck pain, low back pain, shoulder tendonitis, knee tendonitis, they would either, either they can come straight to me or they can go to their doctor and their doctor can refer them for physical therapy.

[00:01:47] So then they would call me and make an appointment. I would evaluate them to see what their problem is, and based on that, I would come up with a treatment plan to see how we can treat them. And, and I don’t wanna say fix them, but manage their treatments and, and improve their, their symptoms and quality of life.

[00:02:01] So it’s more for specific, not injuries, but specific problems they have in terms of, uh, in, in general, um, any, most orthopedic musculoskeletal problems, whether it’s like general pain or if it’s a specific injury or tendinitis. Um, but if it’s something that’s neurologically involved, like a stroke and stuff, they have different clinics for that.

[00:02:23] Oh, interesting. Okay. Right. So they, they have different settings that just deal with that population because they, there’s different equipment and different training for that. Understood. So this is for general musculoskeletal orthopedic injuries. Understood. Or, or pain. Understood. Okay. And, uh, um, I mean, you have treated me for sports related injuries, you know, for weightlifting and those types of things, right?

[00:02:42] Yeah. When you’re doing CrossFit, I remember you had some, uh, symptoms, issues and uh, and also those types of physical, if somebody sprains the leg, for example, and I’m putting it in the simplest form, you, those types of things. Yeah, yeah. Some people to accidents to more serious kind of something. Some people have car accidents, some people have injuries working out, and some people just have.

[00:03:00] Normal aches and pains, and there’s nothing specifically that happened, but their body just has pain just from, it could be from poor posture and disc herniation. So it doesn’t always have to be an injury or incident. Um, you can get pain just, you know, without knowing what you did wrong. And that’s actually where I come in.

[00:03:17] Mm-hmm. Because I would of course, treat the pain and make you feel better, but then as a team we figure out like, why did you have this pain to begin with? What can we do to prevent it from happening? So it’s a lot of brainstorming and figuring things out as well. Right, right. Yeah. Understood. Um, so going back to how you started this, right?

[00:03:33] Mm-hmm. How you started this pra uh, rather like, you know, what, what made you a physical therapist, this field, um, how did you start this practice? Brunswick Spine and Physical Therapy. So, originally this was Brunswick Spine and Rehab. It was a chiropractor. Dr. Stansel and I, we started here, um, 15 years ago.

[00:03:50] Unfortunately, his circumstances changed and he left last year. So I’ve been on my own, a solo owner, um, and transitioned into Brunswick Fanning PT about a year ago. Um, but both of us worked at another chiropractor’s office and we were working pretty hard. We were seeing a bunch of people a day, and the owner that was there was good, but he was like in and out and not taking it seriously.

[00:04:10] So then, Both of us sat down one day and said, Hey, if we’re working hard for this guy and we’re doing all the work, why can’t we just do it on our own somewhere else? Right, right. So he happened to see a, a practice by his office that was up for sale and we took a chance and here we are 15 years later.

[00:04:25] Again, time flies 15 years ago. Right? Yeah, absolutely. And, uh, in terms, I know, I know you discussed this a little bit earlier in terms of common injuries you see, I mean, do you see a common thing being like, you know, Hey, I’ve done this thousands of times, so because, yeah, so because this started off as a chiropractic and physical therapy office and we have the word spine in our office name.

[00:04:45] So the most common injuries that we tend to see is low back pain and neck pain for sure. So yeah, basically, um, People with, uh, low back pain, neck pain, pinch nerve disc herniations, um, either from car accidents or just from sitting all day long. Uh, I would say that’s the number one pain and symptoms that we see in this office.

[00:05:05] Followed by just general, like, you know, pain, knee pain from arthritis, shoulder tendonitis and frozen shoulders, hip pain and hip replacements, ankle sprains, all those common injuries. Okay. But I would say at least 50% of our clients are, are neck and low back pain, neck and low back. It’s a very common. Um, problem I, I guess nationwide just because more and more people are sitting with poor posture and eventually when you sit for a long time, poor posture, those discs bulge out slowly and you can get, you know, pain down the arm or leg and they don’t know what’s going on and, you know, you don’t want to resort to surgeries and stuff.

[00:05:39] So they, conservative treatment is pretty much physical therapy and chiropractic. True. True. Yeah. And so is there any age related? Is it, do you see a specific age group that, that has the common ailments You can say? I would say in the past, like disc herniations were usually middle and aged and up, but I think recently we’re seeing more and more younger people getting it at a younger age as well.

[00:06:02] So I’m seeing as early as people in their twenties with, with disc issues now. Whereas 15 years ago, I don’t think it was as common. It was more like forties and fifties and up. So definitely becoming much more frequent with the younger population because I think more and more people have. Tech jobs, computer jobs, that involved a lot of sitting.

[00:06:20] Right. Right. Whereas 15, 20 years ago, that wasn’t the case before the internet boom. Yeah, exactly. Right. Right. Yeah. Nice. Um, so now know into what I do, you know, more. Mm-hmm. More what, uh, wanted to get some information or rather your guidance on sports specific injuries. Right. So, um, I cycle a lot. Mm-hmm. Um, and I do more, uh, road cycling, mountain biking, all of them.

[00:06:43] Right. Um, so. To begin with, to avoid any sports related injuries. I know cycling is, uh, my understanding is knees are more in constant motion. Sure. You know, they can be some, some sort of, um, related mm-hmm. Fatigue in that area. Right. Anything that, that we can do to kind of reduce the impact or, you know, kind of, um, you know Sure.

[00:07:04] I mean, prepare for, for the rides. There’s, there, there are always things you can do to prevent any, any sports injuries and, you know, flexibility is key and strength is key. Mm-hmm. A lot of people, when they have a specific activity or sport, they think they’re using that muscle all the time, so they don’t, they think they don’t need to do anything extra, which is not true because a lot of runners think that they’re running all the time, so they’re working out their legs, so they don’t need to do anything extra.

[00:07:27] But that, that could, that’s far from the truth. You need to do even more strengthening on top of that because your muscles work in different ways. When you’re cycling, your, your muscles work, your muscle fibers work in different ways than when you’re strengthening, and if you’re not taking care of all the muscle fibers, that’s when you have.

[00:07:43] Muscle imbalances and injuries and stuff. Mm-hmm. So I would say in general, the, the, the squats, the lunges, the step ups, kind of general quad strengthening goes a long way. And I would say in any activity, let’s take cycling for example. Whichever muscles you are using the most, you want to stretch those muscles and strengthen the opposite muscles.

[00:08:02] So, For cycling, your knees are bent a lot. Right. Like a sitting position. So when your knees are bent a lot, your hip flexors will tend to get really tight. Right. Because you’re in that position for a long time. Mm-hmm. So you wanna do like some yoga stretches to open up the hip flexors to stretch that.

[00:08:17] But then you also wanna strengthen the glutes because when you’re sitting down, the glutes get stretched out and they don’t get as much working out. So Understood. So you wanna, you wanna strengthen the opposite muscle group, so, That will help prevent a lot of injuries. And do you provide guidance for those types of activities in terms of, you know, what to strengthen, what to watch out for when, for people who come to you?

[00:08:37] Absolutely. So, you know, I would say everybody that comes into this office is different. I don’t have like a general treatment plan, right? But that’s where the evaluation comes in. So if you’re a cyclist and you come in and you tell me where your pain is, I would most likely look at you and, and, and talk about which activities you do the most and figure out what you’re overusing.

[00:08:55] And what you’re not using enough. And based on that, come up with the treatment plan to see what you need to stretch and what you need to strengthen and all that stuff. Understood. Nice. Nice. Yeah. Great. Um, and, um, for weightlifters, right? Mm-hmm. For people who go to the gym, people who lift by themselves at home, right.

[00:09:11] You know, people in competitive weightlifting, right. Activities. Uh, do you see any common, uh, injuries across these three, these three things? So I do for, for weightlifters, I would say the most common injuries happen to be shoulder pain. Shoulder. Okay. Because shoulders in general have the, the most mobility, but it has the least ability.

[00:09:31] Mm-hmm. So a lot of upper body exercises, especially overhead shoulder press and chest press, people do that quite a bit when they’re weightlifting. So if you don’t have proper posture or strong rotator cuff, And you keep benching and weightlifting, you eventually you’re gonna have some sort of rotator cuff injury.

[00:09:48] So that’s very common. So to prevent that, I would definitely have a good rotator cuff strengthening, um, routine. I would definitely watch your posture. Mm-hmm. And just maybe not lift as heavy all the time. I would change up the amounts of weights that you lift. You know, if you’re gonna go heavy a couple of weeks, slow down and do lightweight more repetition.

[00:10:06] Other way, keep changing it up. If you keep doing the same thing, that’s when you can injure yourself and. For lower body, the most common injury I see is back pain, low back pain. Low back pain. Okay. Usually if you have weak glutes mm-hmm. And a weak core, um, all those squats and lunges and stuff could eventually cause low back pain.

[00:10:23] So would deadlifts also, uh, not warmed up enough lead to that same thing? So deadlifts are a great exercise, but if you don’t have like proper mind body connection with your glutes and your low back, you, you can definitely injure yourself. So if you’ve never done them, You, you need to make sure that you have the basics down first.

[00:10:41] But if you’re a seasoned lifter, then you know, to warm up first and, and all that stuff. But core strength is key for, for the whole body part, upper body, lower body, everything. So some sort of variety of plank side planks, functional exercises. I mean, that’s, that’s key on the days you don’t work out. And also, and also sit, yeah, I mean, so sit-ups, sit-ups work the, the outside muscles.

[00:11:03] Okay. Which are important and back extensions. Mm-hmm. But the core muscles are the deep muscles that surround the spine. Okay. They work, they, they tighten up before you do any movement. Oh, okay. Right. Okay. So sit-ups are good, but it’s not, it’s part of the core muscles, don’t get me wrong, but it’s all, it, it all kind of works together.

[00:11:21] So core muscles are more like, The muscles that work to stabilize your spine while you’re doing a movement. Mm-hmm. Mm-hmm. Right. So when you’re, when you’re dead lifting down to lower, your core has to engage in order for you to hold that weight. If it doesn’t, your back will just slump. Understood.

[00:11:34] Understood. Yeah. And, and you know, if, if a nice, if a good trainer or a PT is looking and we see that, then we know your core is not working. So we would work on those core muscles first by doing the planks and all that stuff, and then lighten up the weight until you really get the form in core. Right.

[00:11:48] Before understood. You progress on the weights. Understood. So, but by watching someone’s form, you can tell. Number one, how strong their core is and how much experience they have with that exercise and activity. Understood. Understood. And uh, like how you said before, in terms of for cyclists working the opposite muscles, right.

[00:12:03] I’m assuming the same theory or same advices? Same thing. Yeah, same thing. Majority, you know, I don’t wanna generalize, but majority of the guys, they, they do a lot more exercises with their chest and biceps and shoulders and they ignore the back as much, so. Oh, okay. The back muscles are the foundation. You need to make sure you actually strengthen that more than your front.

[00:12:22] ’cause we work in front of us all day long, so all those muscles are already kind of tight. Right. So we don’t do enough back stuff. So back stuff like, uh, extensions, back extensions pull, yeah, back pull-ups, extensions, rows, pull-ups. Okay. Um, the lower traps are very important. Understood. Okay. And for the lower body, the key muscle group are the, the glute muscles.

[00:12:39] Okay. Especially the glute meads, which are on the side of the hip. Mm-hmm. That’s like the rotator cuff of your lower body. Oh. Um, so like band walks. Sideline clamshells. Mm-hmm. Those, those muscles are really important because if that’s weak and you go do a squat, you’re gonna have some problems because those muscles are not working properly.

[00:12:54] The load is gonna go somewhere else, like to your knee and to your ankle and stuff. Mm-hmm. Mm-hmm. So I would say for the upper body shoulder, rotator cuff is the most important for the lower body, the glute meets, which are on the outside of the glue. That’s the most important muscle to kind of work on and strengthen.

[00:13:09] Excellent. Right. Thank you, Doug. Thanks for the, thanks for the pointers there. No problem. Um, so as you, as you look forward, right, you said mm-hmm. You’ve been, um, running this practice, um, for the past 15 years with a partner and now by yourself for the past year. Right. Um, where do you see yourself and, uh, Brunswick Spine, you know, Do you have any plans?

[00:13:29] Short-term plans, long-term plans? So yeah, short term and long term, I, I plan on being here. Um, I’m 43 years old, so at least another 10, 15 years I wanna be practicing. I, I enjoy doing what I do. Um, I would like to take on a higher couple of PT assistants and mm-hmm. And see more patients and get more people in here.

[00:13:47] But, um, I don’t plan to open up another office because it’s a very, Hands-on field. I feel like if you’re not there, it’s not gonna be the same. So they can’t make us a too, you need to clone yourself. So listen, you, you know, as a business owner, you have to decide, um, you know, are you a hands-on business person where you want to be there or do you just want to invest and just open up other offices?

[00:14:09] So I decided I to be hands-on. I’d like to be at my business so, I’m just going to, I, I would say stay in this location and expand here by seeing more people and taking more PT assistance instead of expand to your office and more, more personal connect with your patients. Right, right. And I think that’s the type of practice we are as well.

[00:14:24] So more one-on-one, hands-on, like family practice type of place, not like a factory business kind of, you know. Numbers kind of place. Right. Understood. Understood. So yeah, in the next, I would say at least 10 years, I plan on being here, doing the same thing that I’m doing and helping as many people as I can still.

[00:14:40] Yeah. Wow. Good. That’s good. And hopefully that’s good. Education is a big part of my job. So treatment, I love to do treatment, but I want to educate people so they can learn that and they can use that and tell their friends and family what to do, you know? Of course. Right, right. Yeah. Nice. Very nice. Yeah. Um, and for others in a similar situation, right?

[00:14:58] Mm-hmm. If, uh, it might not just be in the medical field, right. For anybody else trying to start a business, right. Any kind of a guidance or thoughts or lessons learned that you would like to share? Sure. I would say the most important thing is enjoying what you’re doing and hopefully being good at it, because once you’re good at a trade or a skill, you have the confidence to really teach other people or actually use your skills and help them.

[00:15:22] But if you are going into a business just for having a business, but you’re not actually good at your craft, that’s gonna come across to the clients and they’re gonna tell that confidence level right away. So you have to gain the client’s trust, and that’s gonna happen with your skillset and your confidence.

[00:15:37] Confidence in yourself. So I would say, You know, do something that you enjoy doing, get good at it. Once that happens, then you can start about the business and everything else will be easy from there because you need to know what you’re doing and, you know, kind of expand on that. Yeah. You need to know what you’re doing and you need to have your clients trust you because you know what you’re doing.

[00:15:56] So businesses are easy once you kind of get down, once you have a passion for what you’re doing and, and you have the confidence and the skillset. Makes sense. Makes sense. Yeah. And uh, um, So that’s great. Um, Esh, you know, thanks, uh, thanks for your time. Uh, I know this was a quick, kind of, uh, introductory podcast with you.

[00:16:18] Not a problem. I actually enjoyed discussing all this. Yeah. And I hope to come back to you with the more, you know, injury specific help, you know, feedback in the future podcast. Hopefully, hopefully not too bad. Yes. And, uh, uh, how can people reach you? Um, Good doctor, so they can go on the website. It’s uh, brunswick spt.com or they can just Google Brunswick’s Spine and Physical Therapy in North Brunswick, and all the information is there.

[00:16:42] Or call to office? (732) 821-9979 multiple ways. Excellent. You open, uh, except for weekends. You open all the for all? Yeah. I’m here Monday, Wednesday, Friday, pretty much all day and Thursday and Saturday, half days. So, understood. Plenty of flexibility. And the website again is uh, brunswick, s p t.com. spt.com.

[00:17:01] Great. Good. Um, once again, thank you Doc. Alright. You wishing you the best. It was a pleasure. Thank you.