Dr. Kathy Dooley: How To Heal Your Body & Get Stronger

What You’ll Learn

• Top 5 exercises to get stronger
• Why every office should have a pull up bar
• The best ways to work on your computer
• The pillow & mattress she recommends
• Why minimal footwear is so important

Listen Now

Listen on Spotify, Google Podcasts, and Apple Podcasts.

Links Mentioned

• Supine 90-90 breathing
• Half-kneeling computer position
• Kneeling chair (affiliate link)
• Sleepgram pillow (affiliate link)
• Turkish get up

About Dr. Kathy Dooley

Dr. Kathy Dooley is a world-renowned rehabilitative chiropractor and co-founder of Catalyst S.P.O.R.T. Dr. Dooley is also an adjunct anatomy professor at two New York City medical schools, Einstein College of Medicine and Weill Cornell Medical College. She is an adjunct professor at New York University College of Dentistry and Sophie Davis School of Biological Sciences and is a visiting professor at Saint George’s University Medical School in Grenada, West Indies. Dr. Dooley is also Lead Instructor on two different seminar series: NeuroKinetic Therapy (NKT), and Immaculate Dissection, an anatomy and palpation seminar which she co-founded. Dr. Dooley is certified as an SFG kettlebell instructor and RKC kettlebell instructor.

Transcript

Marc Perry:
Hey guys, welcome to the BuiltLean podcast. I’m Marc Perry, the creator of BuiltLean, which helps busy men with demanding careers get lean, strong and functionally fit with exceptional vitality, right? And so today I have a very special guest with me, Dr. Kathy Dooley, who’s a world-renowned rehabilitative chiropractor with a very deep knowledge of anatomy. In fact, she’s an adjunct anatomy professor at two New York City medical schools, and she has many teacher pursuits and several certifications including Active Release Technique, NeuroKinetic Therapy, and StrongFirst SFG, just to name a few.

And she is co-owner of Catalyst SPORT In New York City, where she sees patients, and in 2014, I came across Kathy because I wanted to properly rehabilitate my body, and I still had some challenges I was working through from low back surgery many years prior, and I was preparing for the StrongFirst kettlebell certification, and I came to think of Kathy as kind of my personal body mechanic.

And I’ve worked with a lot of rehabilitative therapists over the years, and I’m telling you, Kathy is world class and she’s a teacher to the teachers, and she practices what she preaches, she is strong and she is fit for sure. So with that said, thank you, Kathy, for joining me today. I really appreciate it.

Dr. Kathy Dooley:
Wow, that is such a great intro. I’m so honored that you chose me to help you with your healthcare, and it’s always so great to see someone excel with the kettlebell like you have, and also use the kettlebell not just for strength but in leanness, which of course you are the king of, but also to help you protect your back, which is so great.

Marc Perry:
Absolutely, absolutely, and I really appreciate that. And so, I guess starting off, I’d love to hear more about how did you become interested in becoming a rehabilitative chiropractor?

Dr. Kathy Dooley:
Oh, it’s so great. I was one of those people that didn’t respond very well to traditional Chiropractic, and I was in chiropractic school and I gravitated to chiropractic school because it did help me solve this really bad neck problem that I had, and I was like, “Oh wow, I really wanna do that as my job.” So I worked for a chiropractor for a while, and then she wrote my letter of recommendation to get into school, but when I was there, I was noticing it didn’t solve problems that I had.

Like I would get adjusted or massaged, and things like that, and my problems kept coming back. And I was introduced to rehabilitative chiropractic by a colleague… It was my first semester in school, I got really lucky. And I noticed that the more stable I got, the less I had to stretch, and the more strong I got, the more stable I stayed. And so I was like, “Wait a minute, is this a whole field of rehab?” I wanna do this.

And so, for very flexible people like myself we don’t really respond to chiropractic as well as people that have mobility problems and we have more stability, more control problems, and that’s where our tightness comes from. So no amount of stretching solves it, no amount of adjusting solves it, ’cause we don’t know how to put ourselves in the right place. And I liken it to when you put a parking break on a car, you do it to tighten things up to create safety. And so I wanted to learn more about how to take the parking breaks off for people. And I had to put the lens on myself first. I had to learn how to authentically help myself first before I was gonna be any use to anybody else. And so that’s where it started.

Marc Perry:
Cool, and so I was hoping to dive into a little bit of the exercise stuff right here, and so at Catalyst SPORT your utmost principal is never rob trunk stability to gain fitness. And so what does that mean and why is it the utmost principle?

Dr. Kathy Dooley:
Yeah, it’s a borrowed thought from the amazing great cook, a physical therapist that started Selective Functional Movement Assessment and functional movement systems, and we based everything on that at Catalyst. So it’s basically a way to manage if someone has problems through stability motor control. And a lot of times people will try to rob from their trunk, their lumbar spine area as well, to try to gain mobility in their hips. And the irony is that the thing that controls the hips, knees, feet is coming from the lower lumbar spine.

So if you destabilize that area by creating discogenic changes, by creating pathologies at the lumbar spine, you actually threaten the strategies of the lower extremity. It’s sort of like stepping on a garden hose trying to water a garden. You take the foot off the hose, and then you can water the garden, and that’s what trunk stability is like, being able to create a rigidity around the lumbar spine to prevent its damage, so that the nerves that are going from the lumbar spine down to the limbs are not impeded upon.

And when I started to apply this to myself, and to all of my patients, it resulted in the treatments lasting longer, I’m sure you could share with the group, you didn’t have to see me three times a week for six weeks. That would have been nice ’cause you’re awesome. But it wasn’t necessary. I think it’s not necessary.

Marc Perry:
Okay, and so you were talking about a couple of ideas for improving trunk stability, and essentially your spine stability. What would you do or how would you do that?

Dr. Kathy Dooley:
Sure, so our lumbar spine, basically below the ribs and above your pelvis, right, those vertebrae, they tend towards being bent towards the front. Right, there’s a natural curve that you’ve earned in your low back, and it’s called the lordosis. And your not so earned curve, if you will, is up between your shoulder blades and then down at your tailbone area. And so those areas, they require the support built from the neck and through the lumbar spine, particularly the lumbar spine, and it creates a coil. If you think about like your mattress doesn’t have a pole underneath it, it’ll stick, it tends to have coils, because that takes more compressive loads and you can create buoyancy and disperse any pressure on it like a smart spring in biomechanics, right?

And if you are able to support the lumbar spine by creating what we call neutral spine, which would be a more curved low back, and a less curved mid-back and tailbone area, then what you do is you create the coils. And the way that we do that is I personally like to use things that I used when I was a kid to do that. And babies create those curves in their necks, create those curves in their backs, right? How do they do that? Well, they do that by certain neural developmental progression positions. And Marc, you probably remember, I’d put you through a lot of this.

Marc Perry:
I see it behind you by the way on the wall.

Dr. Kathy Dooley:
You do.

Marc Perry:
On the wall, there it is, yes, yeah.

Dr. Kathy Dooley:
So you feel a little better now.

Marc Perry:
Yeah, sorry.

Dr. Kathy Dooley:
I was very much inspired by DNS, dynamic neuromuscular stabilization techniques. And it was all about watching neural development of the child and how they build what we call… At my seminar series, we call it load share, where you’re able to share loads across the spine where it doesn’t hit one particular spot. So, so many people have lumbar spine problems. Why is that? It’s because they’re bending only at one spot, and they’re not able to distribute force well through the spine.

So I thought like, what’s the best way to be able to distribute force? Watch a kid, and they know how to distribute force they’re gonna face plant because their heads are a fourth of their body weight. So the adult has a different proportion. So we don’t want to move like a baby, what we want to do is we want to stabilize like a baby.

And when people give me flack about trying to use neurodevelopmental positions in the adult, they don’t realize the mistake they’re making, that if you watch a child, they distribute force well, and that’s what we’re trying to emulate is equal force distribution. So I’ll put people on their bellies and on their backs and teach them how to maintain their spinal curves, and then start to move their limbs. They’ll breathe first because breathing helps to protect the lumbar spine. Many peer-reviewed literature studies support that. And then you start to move and ambulate through the arms and legs and you do it on a stable platform so that you’re not threatening the lumbar spine. And it turns out that that frees up movement but without sacrificing the stability of the trunk.

Marc Perry:
So I think this it’s a great segue into breathing. And so I think, you know, when I saw you, it was in March 2014, I had my assessment, and we focused a lot on breathing. And it was like my… I was unable to breathe, I guess like, into my lower back, and into the sides. And…

Dr. Kathy Dooley:
Yeah.

Marc Perry:
I think can you talk a little bit more about why breathing is so important?

Dr. Kathy Dooley:
Yeah.

Marc Perry:
And you actually said, I just want to kind of just reiterate for everyone here who’s listening, breathing must be the primary focus of all corrective and performance exercises. I think you said that at some point. So anyways, can you talk a little bit more about what is the deal with breathing? Why is it so important?

Dr. Kathy Dooley:
It’s my favorite topic.

Marc Perry:
Okay.

Dr. Kathy Dooley:
Especially since we’re in the middle of a respiratory pandemic. It’s breathing… Breathing is really crucial. What breathing does what McGill’s studies have shown, and Stuart McGill amazing spinal researcher, what he found was that by the building and release of intra abdominal pressure, that’s what happens when you breathe. When you breathe in, you build pressure in your gut. And the diaphragm, that major breathing muscle drops down when you breathe in. And if you imagine that decreases the pressure in your thorax around your heart and it allows the lungs to fill with air like a vacuum.

So just like when you turn on the vacuum, that same thing happens every time you inhale, this is a neat way to think about it. So as you increase pressure in your belly, you actually create a pneumatic pressurized system that protects the lumbar spine from moving. Because the truth in life is that if you want to gain mobility, you have to sacrifice stability. And so the lower lumbar spine has the most amount of important nerves coming from it, but has the least amount of structural stability.

And so we have to stabilize it with things like breath, and your air pressure system, if it’s equally shared in load across the trunk can be very good at helping your low back. What we found in you, even post-surgically, was that you never really had that. You never had the ability to breathe into the sides of the ribs, which is biomechanical breathing. And then to breathe into the posterolateral side, the back edges of the sides of the ribs. And that was preventing you from not only exhibiting your maximum strength but by stabilizing your back it was going to free up your hip movement to allow you to do fun things like sprinting without groin pain, swing a kettlebell without back pain, it allows you to stabilize your center so that you can free up the mobility of the legs.

Marc Perry:
And can you talk a little bit about belly breathing versus chest breathing?

Dr. Kathy Dooley:
Yeah, like remember that the chest is a… It’s a pump handle movement, which basically means the chest comes out in front when you inhale. And that’s a passive movement, it requires no muscular activity to push that stuff up. Because if you breathe into the side, the lower sides of your ribs, then what’s happening is the diaphragm drops down, and then it creates a negative pressure in the chest.

So if you breathe into your chest as an initial type of breath, which we call paradoxical breathing, or dysfunctional breathing, what you end up doing is you don’t build that diaphragmatic pressure down, you don’t build the same intra abdominal pressure, and you start to increase pressures into the lumbar spine. And now you just throw off the spring. Now, you kink the slinky, if you will, and now you can’t distribute force through the limbs as well. And also you can’t exchange oxygen as well. They’ve shown that chest breathers have more poor oxygenation of the blood than belly breathers.

Marc Perry:
And so by the way, in terms of chest breathing versus belly breathing, there’s just something I’ve noticed is like you’re kind of you go into a stress mode or kind of fight or flight mode when you’re breathing into your chest. But most people, maybe I’m wrong, you could tell me, it seems like most people, at least, the assessments I have done, breathing into the chest. You do a quick, “Come here, okay, just breathe in.” It’s like the chest goes up, right? So…

Dr. Kathy Dooley:
Yes, I think that we live in a stressful world, I think that we… The thing that babies have on us in a huge way is that they are pre-cognitive, they don’t have a choice, they only do it the right way.

Marc Perry:
Interesting.

Dr. Kathy Dooley:
And as we have this free will and cognition, we can choose to not go back to what we’ve built in the first place, and I have to return to it all the time like I’ll feel myself like take a chest breath, and I’m like… And then you develop that conscious incompetence, you catch yourself doing it poorly, and that’s the only real way to build the competence in the pattern. So it’s okay to fail at it but you have to know that you’re failing. And so a lot of my patients don’t know they’re failing until I teach them how to catch themselves, and then you can re-program what you build as a stress response, ’cause you can train your body when it’s stressed to breathe better. But if you let it go, run amok if you will, you’re basically breathing on autopilot. So you’ll breathe in the way that you’ve trained yourself to respond, and some of our trained responses don’t work well for us.

Marc Perry:
Right, and so we’re also talking… The one thing I also hope you can talk a little bit about is mouth versus nasal breathing. And so one thing when we were working together that made a big shift for me and that helped me open up was I went from a chest breathing and lifting up to just opening up my belly and my abs… Like musculature was restricted. It wasn’t happening. And it took time to open up, and eventually, I was able to kind of breath through the nose into the belly, and it just opened up my body over time. And I’m kind of curious if you can talk a little bit more about nasal breathing versus mouth breathing.

Dr. Kathy Dooley:
Yes, I’m actually giving a lecture on that later tonight.

[chuckle]

Dr. Kathy Dooley:
The timing of that. Yeah. So mouth breathing on the inhale especially. And the exhale, I’m not as strict with as I am on the inhale, and I’ll explain why in a second. So when you inhale, you can either inhale through your nasal cavity or inhale through your oral cavity. The nasal cavity actually has a lot of filtering through hairs, which we all find kind of unpleasant when they’re growing, but they actually serve a really good purpose of filtration and then there’s mucosa, this connective tissue that actually prevents bacterial infiltrate, so it’ll catch things as it comes in and also moistens the air, filters it, basically making sure that the air is clean. And then also in your nose, you have these things called nitric oxide receptors.

Nitric oxide receptors are a part of the immune response, the inflammatory cascade, basically, they’re vasodilators, bronco-dilators. So when you breathe in, you activate these nitric oxide receptors and send a signal to open up the bronchioles, the airway, and you also try to open up your blood vessels and it helps you to slow the blood pressure. It helps you to get an even flow of blood to the sites, which is really important for distal extremities ’cause they get the last hit. And so you don’t have as much of that in your mouth. We don’t have as much hair, we don’t have as much of the mucosa that really can help to stop and filter the air, the bigger space, there’s less total ability to filtrate.

We don’t have these konk shelves in our mouth, but we have them in our nose and help us make the air turbulent so we can clean it. And because of that, on the inhale, I want all of my patients, whether they’re dead-lifting 500, or they’re just doing quiet breathing, I want all the inhales to be nasal. So they can filter so they can activate nitric oxide so they can open up their lungs better, so they go into less stress response, so they can basically get more blood everywhere they need to go. It actually helps to lower blood pressure too.

And then if you mouth-breath, a couple of things happen if you inhale on mouth breathing. There’s this big muscle in your tongue that actually will constrict your airway if your mouth is open on inhalation, so basically if you breathe with your mouth open on the inhale, you make your airway smaller. [chuckle] That’s not good. Whereas nasal breathing opens the airway, mouth breathing narrows the airway. So you’re gonna get less total area. They’ve shown in studies that you actually up to 10% more oxygenation inhaling through the nose rather than inhaling through the mouth, and if you’re messing around with your oxygen, I don’t know. The odds are pretty good, you want as much oxygen as possible, particularly when you’re training, so a good idea would be to make all your inhales through the nose.

Marc Perry:
Okay, interesting. And I remember you at least recommending at the time, you can even go for a jog and breath through your nose, is that something you still talk about?

Dr. Kathy Dooley:
Oh Yeah, I’m really passionate about… My rule is all the inhales need to be through the nose, but as far as the exhales go, if it means you’re gonna lose your belly breathing and you’re gonna start inhaling and exhaling through the nose and you’re gonna start to do paradoxical breathing, I would prefer you to exhale through your mouth to build that gut tension if that’s what you… And maybe sailors do this, power-lifters do this, you’ll see them puff out their cheeks when they exhale and they exhale through their mouth so they can create a sphincter and they slow the exhale so they don’t pass out.

So I think that you can do functional exhalation through the mouth or through the nose, but if the demand is too high, a lot of people can’t lift the 500 and let out pressure through the nose unless they’ve really trained it. So yes, you can do everything through the nose, but if you can’t currently do everything through the nose, at least do it on the inhale.

Marc Perry:
Okay, and so let’s talk a little about pain and injury in general. One thing you’ve talked about regarding chronic pain, and certainly most of the people I would say who are listening have had chronic pain, most of us have had it at some point, and you talk about you must build a new pathway, remodel and rebuild, what do you mean by that?

Dr. Kathy Dooley:
So if somebody has pain past one year, they’ve now entered a brain remodeling at the back of your brain it’s called the parietal lobe, where it’s receiving all these pain signals, you actually create what I call a German Autobahn, no stops, the speeding is not even matched, you basically create a pathway to experience pain or nociception without an injurious process necessarily even being present. And this is a hard sell to be able to tell my patients, “Nothing is actually wrong with you, and it’s just a highway you keep going down.” And then they’re like, “How is that possible that pain is not injury?” and I’m like, “Actually, they’re completely separate entities,” and I tell them some injuries aren’t even painful.

I have patients that completely rupture a ligament and feel no pain, they just feel instability, and then I’ll have patients that do a grade one sprain of a ligament and feel enormous discomfort because of an inflammatory cascade. So pain and injury are not the same, and if you have pain past a year and it’s chronic, you have created a pathway that you have to now re-model, which means you have to dig a dirt highway to follow next to the German Autobahn, which takes effort, it takes failure, it takes rebuilding and it takes time. And some people are really impatient with pain ’cause it’s so uncomfortable, it’s noxious reception, nociception, so people will take pain pills or muscle relaxants, they’ll do all kinds of different therapies to try to kill pain. And a part of that process has to be remodeling, if you don’t remodel the way the brain perceives that discomfort, then you’re always just trying to ameliorate pain instead of actually preventing the reception.

Marc Perry:
So what are some ways to… Can you give an example of what remodeling is?

Dr. Kathy Dooley:
Absolutely. So if someone who comes to me with a hip pain and they’ve had chronic hip pain for a year, they may have a perceived threat of getting in certain positions, like one position, you probably always saw me in was kneeling. I’ve had a hip problem, so I’m always gonna kneel because I know it centers my hip and prevents pain, it builds a new pathway, but if I sit too long like in a car, I might feel my pain again because I went down the old highway. And so what I teach people to do is choose new things. If they have an exacerbatory position, something makes them worse, like sitting, then sit in a different way, or choosing a different neural drive for something. Like if they squat, but it’s too painful on their back, maybe back squatting isn’t right for them, maybe they need to front squat. And so just those little tiny changes can actually remodel and change the way that they perceive their environment, which can result in less discomfort.

Marc Perry:
Interesting, alright, and so let’s talk a little bit about some kind of practical exercises. A lot of guys who are listening, I think we just wanna create something practical like, “Okay, this is something you can take away.” And so one question I had was, what are some of your top few exercises to help someone, I guess, rehabilitate or just get stronger and improve their body.

Dr. Kathy Dooley:
Absolutely. I’m happy to send you links to these too.

Marc Perry:
Okay, cool.

Dr. Kathy Dooley:
They’re all on my YouTube and it’s completely free guys, it’s not monetized, I want you guys to just enjoy it. One of the most important drills, I think, for building a full body stability and strength would always start with breathing, obviously, so it’s a drill called Supine 90-90. So you would start on your back with your legs in the air, and of course, I’ll send you a video of doing that properly, then I would roll them over to their elbow and start them through the phases of the get-up. And the get-up is how we get ourselves out of bed, it’s how we actually trained ourselves to walk before we could walk. And it’s a full body strategizing of getting off the floor and standing up and involves rolling over to an elbow, pivoting oneself onto an elbow, sweeping a leg underneath them to go into a kneeling position, and then going from kneeling to standing. And then you reverse it and then you would start adding load to it, and that is one of the best exercises on the planet.

The third exercise I would give that’s inside of the get-up is practicing lunging as much as possible, whether it’s for your work, if you’re on the computer, or if you are just trying to take a knee when you’re trying to observe something, I want… I practice eight or nine hours a day in kneeling, and it’s really important because it protects the back, it protects all of your movement sub-systems to help everything hold together nicely and babies do this at 11 months. It actually is quite challenging. People are in love with the squat and they’re in love with dead-lifting, which I love those things, but I love lunging way more. I think lunging builds full body stability, mobility and strength better than any exercise on the planet, and it’s built in the get-up, so you can either practice more get-ups or you could do lunging separately.

The last two things I would suggest would be swinging and snatching. So, swinging the kettlebell it means… For us like the Russian kettlebell for Marc and I would be ending the kettlebell swing where it lines up with your chest, and I like that in case somebody has a shoulder problem. The thing that’s the best in the world is the snatch, but as Marc will tell you, it takes an evolution of understanding how to do that well, and if you have a thread of that, I have a video I can show you on how you can train yourself to do these things called high pulls, which prepare you for snatching, which I’m sure Marc has endured.

The swing and the snatch, the reason I like them is they build VO2 max and they build that cardiovascular capacity, but while also building strength. A lot of people wanna get lean. They wanna be fit, they wanna be healthy, and I think a swing or snatch whatever they can do appropriately or a mixture of both, they build that cardiovascular capacity. They burn body fat, they keep you very lean, but also make you very strong, and there’s just not a lot of cardio that also makes you strong at the same time unless you’re doing everything perfectly.

And I think running is really challenging to do that way, elliptical doesn’t really build bone density. There’s things that are missing, I don’t think anything is missing from the swing or the snatch. And if you’re really trying to improve your breathing, trying to improve your energy levels, and if you wanna incinerate body fat then this swing and the snatch are two fantastic choices. So those would be my big ones. Like starting with the breathing practice, moving it to the get-up from the breathing practice, really getting good at lunging for full-body power.

Marc Perry:
You mean like sideways, forward, backwards?

Dr. Kathy Dooley:
Oh yeah. Every direction.

Marc Perry:
Okay. [chuckle]

Dr. Kathy Dooley:
And turning that into step up, step down are forms of lunging. Yeah. And then swings or snatch or a combination of both.

Marc Perry:
Okay, that’s awesome. And one of the things that I think also had a huge impact on what we worked on was just some of your lifestyle tips like you’re talking about kneeling, for example, I actually saw you half-kneeling and working on a computer, and I’m just like…

Dr. Kathy Dooley:
Oh yeah, all the time.

Marc Perry:
This is interesting. And I used to sit down and work on a computer, and that’s kind of how… And then I wonder why I’m just unable to improve my shoulder mobility, and I always around… It’s like you’re kind of pulling a rubber band and it just goes back in place.

Dr. Kathy Dooley:
I loved that you said that Marc. A lot of people don’t equate shoulder mobility with their hips, and that’s a big mistake and I’m glad that you didn’t make it. When you kneel, what happens with the baby is that at 11 months, they kneel and they’re trying to push themselves up. And when they can get 100 degrees of humeral flexion, which is what most people want. They wanna be able to reach their arms overhead, once they can do that they stand up, which means that your arm is connected to your hip via these obliques. It’s a really important connection. So if you want to build really good shoulder mobility, one of the things I have people do is kneel and teach them how to push themselves up and you wouldn’t believe how hard it is for them. It’s so challenging.

Marc Perry:
Interesting. And so regarding some of the lifestyle stuff. So for example, I guess we’ll start with a general question and dive in from there. So what lifestyle tips would you give to help guys who work on a computer a lot, who feel pretty stiff, improve their health and well being?

Dr. Kathy Dooley:
One of the best tips, I have two big tips. One is to kneel as often as possible. That’s an obvious statement. So working and kneeling. I can send you a video of me coaching through that if you want for your community. The next one is, get your elbows on something. The best thing you can do is remember who you were as a kid when you were pushing away from your elbows. And so most people, their elbows are hanging off of their desk and they’re not on their armrests and they’re hanging in the air, and I think that’s a big problem. I want their elbows on something so that they can physically push away from their elbows, and that’s one of the ways to keep your posture upright. The baby uses their elbows like crazy, but the adults barely ever do. We’re taught to keep our elbows off the table, which is an epic mistake.

Marc Perry:
Interesting.

Dr. Kathy Dooley:
We should have our elbows on the table all the time. So I’m in a restaurant, I have my elbows on the table and I push.

Marc Perry:
Ah!

Dr. Kathy Dooley:
Yeah. So break those etiquette rules, please, for your own safety.

Marc Perry:
Interesting. And any thoughts on standing desk, because I know you’re doing a… And by the way, when you say, when we’re talking kneeling, we’re talking half kneeling, which is pretty cool. I don’t think a lot of people who are listening have heard that. So I just want to be curious…

Dr. Kathy Dooley:
Oh yeah, I’ll send you a video.

Marc Perry:
Yeah, yeah, you can send me a video and I’ll share.

Dr. Kathy Dooley:
‘Cause I don’t wanna waste the whole time talking about kneeling although I could talk about kneeling for like 15 hours.

Marc Perry:
I’m sure, I’m sure you could.

Dr. Kathy Dooley:
So I’ll send you guys the video, but… Yeah.

Marc Perry:
Like standing or half-kneeling? Yea, like standing or half-kneeling.

Dr. Kathy Dooley:
Yeah. Kneeling on one knee or kneeling on two knees, any kind of kneeling I’ll take but I really like it on one knee like a half-kneeling and then getting my elbows on something, so those two things together are magical.

Marc Perry:
And any opinion on standing desk or no?

Dr. Kathy Dooley:
They’re not my favorite.

Marc Perry:
Why?

Dr. Kathy Dooley:
The reason why is that standing desk, standing is still creating a problem for a lot of people where they’ll shift to one leg, shift to the other leg, hyperextend their back, still slouch. I think it solves part of the slouching issue but you still can’t get your elbows on something. Unless you have your elbows on something, you’re still not supporting the neck. The neck starts looking at the computer, and I feel like I see a lot of people that the standing desk help maybe with their back, but now they’re feeling their hip or their knee or their neck, and I’m like, Okay, it’s like robbing Peter to pay Paul and instead of just paying both Peter and Paul.

So I do think the kneeling chairs by the way, are a good substitute for a chair. But I don’t think standing is bad, it just wouldn’t be my… It’s not something I’d do. It wouldn’t be my first choice. But if you like it, if you get something out of it, by all means, do it. So maybe you do a mixture of them. Maybe you do a little bit of standing desk and maybe do a little bit of toe kneeling and maybe do a little bit of sitting, and maybe the solution is doing a little bit of everything.

Marc Perry:
Okay, and do you have any thoughts on footwear? ‘Cause I know that at Catalyst, it’s barefoot training, and I think you wear a little bit. So any thoughts on footwear?

Dr. Kathy Dooley:
Yeah, I personally can’t wear anything like a vibrant five finger because it spreads my great toe away from the second toe too much. And I have a condition where that already happens too much, so I can’t wear those, but I wear Merrell Vapor Gloves everywhere. And then I wear very, very flexible boot made by bogs for the winter, and it’s hard to get me out of either of those shoes. The only time I did was when I got married, I wore a heel for 15 minutes and I was out of it.

[chuckle]

Dr. Kathy Dooley:
I’ve had too many problems. So for your community, like the dress shoes become a challenge because they have a little bit of a lift and they are also very narrow in the forefoot. So I have a lot of gentlemen come to me with problems in their feet and the ankles and knees because the shoes not flatter but luckily for you guys, there’s some pretty industrious people out there that have created minimalist dress shoes. And you can start with those or maybe just training without having shoes on.

The reason why is because there’s 10,000 sensory receptors on the bottom of your foot. And if you have a shoe on with a big thick sole, like an ASIC or a Saucony, nothing against those companies, it’s just that I can’t feel anything. And if I want my body to react and my hips, knees, all of it are wired to my feet, then I want to feel my feet, and some of my patients are so uncomfortable when they first do this that it’ll almost talk them out of it, but just because they’ve never barefoot. And then as you start to build up the stability and density of the foot, you wake up those intrinsic muscles of the foot, which you have over 20 of them in the bottom of your foot, then what happens is you start to have better spatial awareness, better tuning into the hips, better stability for your back, because the hips help stabilize the back, and then you end up not going back, which I won’t go back to wearing a heel.

Marc Perry:
Interesting, okay. And any…

Dr. Kathy Dooley:
I’m a huge advocate.

Marc Perry:
Okay, and any thoughts on… ’cause one of the things we even talked about was a pillow and mattress, any thoughts on what pillow you recommend using or a mattress? Should it be stiffer? What are your thoughts on this?

Dr. Kathy Dooley:
Yeah, I think the stiffest that you could do… It should be stiff like a massage table stiff. I really like a stiff mattress. We had to design ours, it got really… We got stiff mattress we could buy, and then we had to put a piece of plywood between it and the box spring, and then we had to put one of the foreign pads on it to make it stiff enough for me to be okay with it. I don’t think they make mattresses stiff enough at all, and I think it causes a lot of back problems. The back wants a hard surface and that takes some getting used to, but when people have acute back injuries, they always talk about laying on the floor, that the bed makes it worse.

Marc Perry:
I think that’s really… It’s really interesting. I think it’s interesting ’cause it’s just different from what I think many people hear because there’s a lot of marketing. So what about the pillow, any thoughts on the size of the pillow or using no pillow? No pillow or pillow?

Dr. Kathy Dooley:
Yes. I have a pillow. I’m gonna send you a video I made on this too, so you guys will have lots of support videos in case you’re interested in this. If you’re laying on your side, you need to have support that leaves your nose in line with your breast bone, so if you’re on your side, you don’t want your head hanging and tilting to either side. If you’re on your back, no pillow, and if you’re on your belly, you need to have a body pillow between your arm and your leg so that your head doesn’t crank. So again, the nose needs to be in line with the breast bone.

So if you’re on your belly on your side, nose in line with breast bone, any pillow that you have that can create that then… Honestly, some people like Tempur-Pedic, I don’t like Tempur-Pedic because when I flip over onto my back, then my head is cranked up and so it’s not for me, but really you have to figure this out for yourself and figure out what works for you. I use the Sleepgram. I really like that because you can change the pillow to have more density on one end than the other, so my pillow is very flat on the left side, so that when I lay on my back, there’s no support, and then when I roll to my side, it has more pillow so that it neutralizes my neck, and that has helped so much. So the Sleepgram has three inserts inside of it, it’s pretty cheap, I think it’s like 60 bucks and magical.

Marc Perry:
Interesting, alright, I’ll look into that. And then regarding… And I know we’re coming up on time here, you probably have patients you need to see, I think one of the tips you’ve given in terms of… Okay, what’s a practical tip for someone who’s sitting down at a computer most of the day, it’s like, how does someone like that improve their mobility and just build it into that lifestyle, and I think one thing you mentioned was potentially put up a pull-up bar in your living room or your office and just hang from it. Can you talk a little bit more about that?

Dr. Kathy Dooley:
Absolutely, if I could put a pull-up bar in every office in all the world, I wish that I would just hit the lottery, so that’s the first thing I would do, I would just send out pull-up bars to everyone because they’re really cheap and they’re easy to install, and you see it, you get that cue to go hang from it. And let’s face it, we’re primates, we’re supposed to be hanging from stuff, and I’m not so sure that our bodies are designed to sit behind the computer all day. So if you can break up that tension by go brachiating, go hang from something, it can really, really help. I’ve already hung like three times today. It’s really, really, really helpful.

The second thing is changing your positions often when you’re working. Most people stay too fixed at one position, it’s usually seated or standing. So sit a little, stand a little. Sitting is not bad, it’s just not good to do all the time, so sit a little, stand a little, kneel a lot, [chuckle] Or use a kneeling chair where you’re being forced to kind of posture up a little bit. I think it was Stuart McGill who said, “The best position is the one you’re not in longer than 15 minutes.” I really love that, I think you should be more fidgety and start to change your work environment.

We fixate our work environment and that benefits no one. You should be moving more throughout your day. Why is your desk always in the same place? Ever thought about it? It’s just for convenience for who? It’s not for your body, maybe for your mind, I guess, but I don’t know. I feel like you should change positions a lot, it improves circulation, the more you stay in one spot, you’re impeding circulation of something. Circulation isn’t my major focus in my patients, I want blood moving, I want lymphatics moving, I want their bodies moving, so if I wanted to improve mobility, I’d improve circulation. And so just change your position as often as possible.

Marc Perry:
Cool. Well, let’s end on that. And so, how can people learn more about you? How can they find you?

Dr. Kathy Dooley:
Oh yeah, so I’ll send you guys… I’ll send Marc some of the videos we talked about, and so that’s all on my YouTube. If you guys wanna go on YouTube, it’s Dr. Dooley Noted, and I’m happy to send you a link to that, and I’ll give you my personal email, if you have questions, feel free to write. They always say if you want something done, give it to a busy person so I return emails within 24 hours typically, if I’m delayed, I’ll let you know, but I’d love to answer your questions. I think it’s great what you folks are doing tuning in to Marc’s podcast to learn more about how to help yourself. I am a huge advocate of doctor meaning teacher not fix your stuff. So I’ve been very proud to be in Marc’s healing team to help inspire and catalyse and helping himself, and I hope that you guys will do the same.

Marc Perry:
Awesome, well listen, Kathy it was awesome catching up and enjoy the rest of your day.

Dr. Kathy Dooley:
Thank you Marc. Bye.

Marc Perry:
Alright, bye-bye.