Eric convinced Dr. Paul Cagle, a world-renowned shoulder surgeon still in his scrubs after conducting surgery, to join the podcast and speak about shoulder and back injuries, preventative care, and the seemingly small injury risks we all encounter when servicing swimming pools.
00:00 - Introduction
02:10 - Dr. Paul Cagle, shoulder surgeon
06:02 - Scenario: lifting heavy buckets in and out of a pickup truck bed
11:32 - Protecting your back muscles
17:27 - Preventative strengthening exercises
21:06 - Most common shoulder injuries that lead to surgery
25:47 - Brushing a pool safely
[00:00:00] Eric Knight: Welcome back everybody to the Rule Your Pool podcast. This is episode 145. And it's a special episode. I've been talking for a while about having some very cool guests on the show this year. This is the first of about four or five of them that we have booked. And this is a really cool guest because he has nothing to do with swimming pool chemistry. He has everything to do with your health and well being.
[00:00:22] We are honored to have him on here a world renowned shoulder surgeon, Dr. Paul Cagle, joining us. Paul, thank you for being on the Rule Your Pool podcast.
[00:00:30] Dr. Paul Cagle: Eric, thank you for having me.
[00:00:31] Eric Knight: Yeah, happy to have you here. Just so you know, this is a podcast where we have a lot of pool owners and pool professionals listening to it. And the reason I wanted you on Paul, why I reached out, was you know that I had shoulder surgery as a competitive swimmer. I'm watching Olympic Trials right now. And I remember when I was at Olympic Trials, a good 30 percent or more of the Olympic team and a lot of the people at trials had shoulder scars.
[00:00:54] So many of us have had shoulder surgery because of these repetitive stress injuries. And pool pros have very similar injuries. We see a lot of shoulder problems. And customers say, Ah, you know, I threw out my back, I hurt my neck, I was getting a bucket out of my truck. Or sometimes it happens when they're netting a pool or brushing a pool with force, holding a pole, like pushing it down the inside wall. And you have a swimming pool, right?
[00:01:19] Dr. Paul Cagle: I do.
[00:01:20] Eric Knight: Yeah. So if you're netting that pool or you're brushing it with force, injuries can happen. And that's why I wanted you to be on this show. And since you're a shoulder surgeon, we'd like to talk about preventative care and what shoulder injuries are, and what can we do to as pool professionals and pool owners to make sure that we don't get injured to a point where we need to see you.
[00:01:41] Sound good?
[00:01:42] Dr. Paul Cagle: That sounds great.
[00:01:43] Eric Knight: All right, let's get into it. This is episode 145 of the Rule Your Pool podcast.
[00:02:10] Eric Knight: So before we get into this, Paul, you've been doing this a long time. What got you into medicine and what specifically got you into shoulders?
[00:02:18] Dr. Paul Cagle: I think medicine is, as we often say, a vocation or a calling. And so I think it's one of the fields that people sometimes feel themselves drawn to. And thankfully it's one that I believe you find more and more affirmations as you get further into it. So it's very, very lucky to have that sort of understanding early in my life. And it was sort of a straight track pathway, meaning I really didn't take any time off in between, and loved it since.
[00:02:42] Um, the shoulder is a really great place to be. And the shoulder is a unique area of orthopedics where we can still take care of what is really the full gamut of care. Meaning elite level athletes like yourself, weekend warriors, younger individuals with injuries, people with fractures, elderly individuals with arthritis and everything in between.
[00:03:03] And that breadth of opportunity is really one of the things that attracted me there.
[00:03:06] Eric Knight: Mhmm. As you know, I had shoulder surgery from swimming with bad technique over and over and over again. Just doing tens of thousands of meters a week. You know, In swimming, you're just kind of told, grit and bear it. You know, it's part of it. Everybody hurts. You just got to keep going. You got to keep going.
[00:03:25] In this world, in pool care, our customers have to keep going. This is how they feed their families. You've got to get another pool in. You have to go visit because that's their income. It's their livelihood. And a lot of people just push through injuries.
[00:03:39] What are the injuries that you see? Because you're not just a orthopedic doctor. You're a surgeon. You're like the last step, right?
[00:03:46] Dr. Paul Cagle: That is true.
[00:03:46] Eric Knight: What is the process of professionals that I would see before I get to you?
[00:03:51] Dr. Paul Cagle: The usual progression, is depending on if it's a injury or if it's overused. Many times if it's an injury, meaning you had a single time event. People might be seen in urgent care. If it's overused where it's happened gradually, many people are managed by their primary care physician.
[00:04:07] Sometimes, you know, individually, I mean, they never need to see a surgeon. Our primary care colleagues do a really good job of this. And they'll often be managed what we would call non operatively, with things like physical therapy or anti inflammatories.
[00:04:20] As you sort of pass that, meaning you're not responding to the therapy, you're not responding to the anti inflammatories, oftentimes we would go towards advanced imaging and as that demonstrates true pathology, you really be referred to a surgeon.
[00:04:33] Eric Knight: Advanced imaging, meaning like an MRI?
[00:04:36] Dr. Paul Cagle: MRI is probably the most common. Sometimes it might be a CT, it could be an ultrasound, but I would say MRI is probably the most commonly ordered test nowadays.
[00:04:44] Eric Knight: Right. That's what I had. Now, let me take a step back here. I know what the answer is, but our audience may not. You said orthopedics before. Can you define that? What is orthopedics?
[00:04:56] Dr. Paul Cagle: Orthopedics in medicine is really the care of the musculoskeletal system. So that means it's a care of bones, joints, tendons, majority really what helps us move and get around and sort of support the, the vascular structures. So it's really primarily going to be your joints, your tendons, your muscles, and your bones.
[00:05:16] Eric Knight: Got it. Okay, cool. And you gravitated towards shoulders. Shoulders of course, being a very complex joint. Is it, is it a shoulder, a joint or is there a different term for it medically?
[00:05:25] Dr. Paul Cagle: It is. It is. It's one of the joints with the highest degrees of freedom, meaning it's one of the joints that has the most motion. And that is the crux of what we're going to talk about today, because as you have those joints that have more motion, then there's just more opportunity to injure them.
[00:05:39] Eric Knight: Right, right. I certainly know what that's like. As compared to something like an elbow, which has, you know, open and close, basically. Right?
[00:05:48] Dr. Paul Cagle: Yeah, I like to give my elbow partners a hard time about that as well. The elbow definitely has more inherent stability to it. And that sort of inherent or bony stability does sometimes give you a lot more protective structures.
[00:06:02] Eric Knight: Okay cool. So let me give you a little bit of a scenario here. And I want you to just visualize with me, along with the audience. And I just want you to give me your honest opinion of what am I doing wrong? And just talk to me as if I'm a pool pro, and you're standing next to me, and I'm doing this at my truck. As an expert, talk to me so that I don't get hurt.
[00:06:24] Just try your best. I know I haven't prepped you for any of this. But I'm walking up to the edge of a pickup truck and I've got a 50 pound bucket of dry chemical.
[00:06:34] I'm going to pick up that bucket. I'm going to get it up above my belt and I'm going to hoist it up over the side and I'm going to push it down and try to softly land it down into the bed of the truck, over the side. Like, you know, by the wheel well. What am I doing wrong?
[00:06:48] Dr. Paul Cagle: Probably a variety of things there could get you in trouble. So the first to think about is your shoulder. Let's say you're holding a weight in your hand. If that's at your side, it really isn't, as heavy, so to speak, to your shoulders, if you bring that away from your body, right?
[00:07:03] So as you bring your arm further and further away from your body, or your hand almost horizontal with the ground, now because of the lever arm and the length of your arm, that weight is going to feel a lot more strenuous or heavy than if it were at your side.
[00:07:16] I think the first thing to think about is obviously trying to keep these heavier weights a little bit closer to you so that you're not putting that big lever arm, so to speak, on your shoulder.
[00:07:26] The second part of this that is where people get themselves in trouble is what's referred to as eccentric contraction. So in the gym, we call these negatives, uh, meaning that it's where you're letting the weight down while you're contracting. But this is what you're doing as well when you're lowering these types of buckets or you're trying to bring these things over an area.
[00:07:47] And eccentric contractions are really hard on our muscles. Because we're lowering something down slowly. The muscle instead of contracting is actually getting longer, meaning you're letting it down as you're trying to hold the weight or hold, in this case, a bucket. And in this case it might be swinging and so a little momentum plus that eccentric motion is actually one of the things that can really get people in trouble.
[00:08:10] So one of the things you really want to do here is really limit that amount of motion. Meaning if you have to lift this over, try to make sure you're not swinging it. Try to make sure there's not a lot of momentum going into it. So there's not that added pull or instability as you're bringing it up or over.
[00:08:24] The last part of it, you know, which is obvious is that if you can use some type of adaptive aspect, if you can get on a quick step, or if you can use something where you're standing a little bit higher, this would mean you wouldn't have to lift it quite as high. Which is going to put less strain or stress on your shoulder. And I realized that's going to be situationally either available or unavailable.
[00:08:44] Eric Knight: That was actually my next question. I remember from swimming we were talking to our team doctors and our, our weightlifting coach, I should say, who got his instructions from our trainers and team doctor of what you should do in the gym and what these swimmers need to be stronger in.
[00:09:00] And he was saying, we want to strengthen with very light weight above the height of the shoulder. So anything from the shoulders up with our arms, Yeah, you need to strengthen it, but we're not lifting very heavy above the shoulders. And I think it's probably because of that. So if we do shoulder raises with dumbbells, for instance, we go basically to horizontal and not much higher.
[00:09:21] And what I'm gathering from that is if I can maybe stand on a step stool or stand up on a curb, then I can lift more with my legs. I'm higher up, so I'm not getting as high in the shoulder and then I can put that weight in safer. Is that what I'm understanding?
[00:09:37] Dr. Paul Cagle: Yeah, you had really good people talking to you there. I mean, what they're trying to say to you in a very articulate way is the whole no pain, no gain thing is not very smart, right? You want to get to a functional arc of motion, which is what they're describing, to where you can get the muscle stronger and you can work it, but it's not taking it to a point where it becomes unsafe.
[00:09:56] And the same principles apply to lifting the bucket. If you can keep that as sort of that sort of safe arc of motion or safe plane of motion, it's just going to be easier on the individual lifting it.
[00:10:07] Eric Knight: Sure. Now, I, when I think of this, of the lever arm, I think of the Beerstein challenge where if you hold out a full liter of beer in a big glass, like, Hofbrauhaus Beerstein with a straight arm, it's very hard to hold it.
[00:10:22] And you might be able to hold it for a minute, but not much longer. Whereas if you're holding it close to your chest, it's no problem. You can hold it all night. That's what you mean by the lever arm, right?
[00:10:30] Dr. Paul Cagle: Exactly right. Yes.
[00:10:32] Eric Knight: For those of you listening, You don't have to be a pool pro to be able to hurt yourself by accident. I will give you an example. I was cleaning out my garage the other day and I'm a reasonably fit guy. I'm pretty strong. I was trying to pick something up and get it over this little shelf that I had because it was behind the shelf and I didn't, I couldn't really walk around behind it. Not very light, maybe 25 pounds.
[00:10:57] And just that motion of lifting it up went all into my back and all into my shoulders. And I felt this little tinge in my shoulder. And I thought, Oh no, I'm in trouble. Because I know what that's like from swimming. And I thought just how stupid was that for me to do that? I know better.
[00:11:15] And I think we find ourselves in a situation a lot where we're maybe we're in the backyard and we can't really reach something because the way the pool equipment is configured, we have to lean over the pump or the filter to get to something to maybe unscrew something. Or take the drain plug out or something like that.
[00:11:32] Eric Knight: And we find ourselves contorting ourselves in the backyard in weird ways. And part of the reason I have Paul on here is because I have heard from several of you who throw your back out. So Paul, I want to pivot a little bit. We'll come back to the shoulders. We have a lot of back injuries. A lot of people twisting their back.
[00:11:50] I know you're not a back specialist per se, but you are an orthopedic surgeon, so I'm going to guess you're more qualified to answer this than anyone else I know. But, um, what do you have to say about lower back injuries lifting heavy stuff?
[00:12:02] Dr. Paul Cagle: So I think we all could have a stronger core. Um, there's some pretty good data out there in the world that core strengthening, obviously there's a variety of ways that you can do that. Sit-ups are obviously the most understood. is something that really can help prevent those injuries.
[00:12:18] The second part of it is just education. So actually one of the most effective ways to avoid back injuries is what you're doing right now, which is a great public service. Which is just back education, right? And so you can actually decrease back pain, decrease the rate of injuries, decrease problems, simply by having education about how to pick things up or how to stand up or things like that.
[00:12:41] Probably the biggest important aspect of this is what you don't want to do is you don't want to lift with your back, right? And so I think sometimes it's easy. We don't want to bend our knees. We don't want to get down We don't want to get in sort of that position where we're almost squatting. But that's a lot safer than lifting from our waist or our back.
[00:12:58] Eric Knight: What about rotation? Because again, I'm trying to replicate what pool pros do every day. If I'm standing next to a truck, I've got stuff that I need to pick up, get over the edge of the truck, twist, and put it into the truck.
[00:13:11] Dr. Paul Cagle: Yeah, a hundred percent. Any rotation or any additional plane of motion is going to increase that likelihood for two reasons. One, you're asking more those sort of stabilizers of your core now. So it's not just a single plane of motion, it's a complicated rotational plane of motion. And the second part of this is that, again, kinda like we talked about before, you can get yourself in sort of a funny position like that momentum discussion.
[00:13:34] And whether you're trying to or not, you may put yourself just a little bit past that aspect of that degree or rotation where your muscles really can tolerate. And those are two things, obviously, to really keep in mind and try to avoid.
[00:13:49] If you can avoid the rotation in general, it's probably better.
[00:13:53] Eric Knight: How can you avoid that? Do you have to reposition your feet?
[00:13:57] Dr. Paul Cagle: You might. You might have to reposition your feet. It may have to do a little bit with how, you know, getting the object in, in two steps as opposed to one. There's a lot of different situations here you can find yourself in. But awareness alone will decrease the number of back injuries.
[00:14:12] Eric Knight: Okay. That's really good. Now let's shift up to the rhomboids and I wouldn't say deltoids, but the rhomboids and the traps. Basically the muscles that connect the upper back to your neck. I personally, this is what gets me. That's where I have the most pain. I carry a lot of stress in there, but I know customers do too.
[00:14:31] Especially when you're picking up a bucket or two, like maybe you have one on one side, let's say it's a 50 pound bucket, and you're walking all the way from your truck into the backyard. And you're lopsided. I've got it on my left side in my left hand. I don't have any weight on the right hand. So of course my right hand is a wing to counterbalance. What's the risk there? And what could we do to alleviate that?
[00:14:55] Dr. Paul Cagle: Yeah. So there are frustrating little muscles and there, I think the best description of them is sort of short arc muscles. Meaning if you look at your bicep, it's a nice big muscle that you can take through a big arc of motion. You bring your arm all the way straight. You can bring it all the way up. Relatively easy to work, relatively easy to see, relatively easy to rehab.
[00:15:13] When you talk about the muscles on the inside of your shoulder blade, your scapula, meaning your rhomboids, and a variety of other sort of levator muscles there, they're relatively short, stubby kind of muscles. They don't move very easily, and honestly, they're pretty hard to work.
[00:15:29] I have challenged many people to tell me if they find a gym that has a scapula or shoulder blade machine in it, but I've yet to have anyone tell me that there's a shoulder blade machine in their gym. And that's hard because you go to a gym and there's 50, a hundred different ways to work your bicep and there's zero ways to work your scapula muscles.
[00:15:48] Eric Knight: Interesting. Not even a cable column?
[00:15:50] Dr. Paul Cagle: You could, but it does require a little bit of knowledge then, right? Unfortunately you have to have a little bit of understanding of the motion the rhomboids do. And honestly, I think you really got to have somebody watch you. Because it's, for most of us, not intuitive to know that the muscles in our back are contracting the way we want them to or not.
[00:16:08] And obviously it's pretty hard to see, given they're in the center of your back. Um, so I do think if you have a, you know, a tweak or a pull there, it's good to be a bit more proactive. It's one of those things that's kind of hard to work out on your own. It's kind of hard to just go stretch it or work it at your local gym, fitness center, basement, what have you. Just because you can't really see them independently. And it's unusual to have those exercises as part of your normal routine.
[00:16:33] From preventative aspects, you know, this again, probably gets into a little bit of just probably lifting a bit too heavy, or repetition. Repetition is hard to avoid. That's part of, you know, everybody's life, work, sports, careers, things like that. But some of the heavier lifting, you can make the object lighter, or again, you know, some of the physics principles of just keeping it closer to yourself, it makes it lighter. That may also help.
[00:16:57] Eric Knight: Interesting. maybe it's just counterbalancing, maybe carrying two buckets, cut the weight in half if you can. You can't always do that though.
[00:17:05] Dr. Paul Cagle: Yeah. And that's the hard thing. Giving solutions that aren't practical is not very helpful. And so I think some of these things are really just a little situational awareness as well. It's easy to get focused on the task at hand. But sometimes having in the back of your mind, you know, hey, I don't want to over rotate this because I can have a little muscles in the back don't take a joke very well. You know it's something that may be having your back pocket.
[00:17:27] Eric Knight: Yeah. What about band work? Like light bands and what kind of exercises could we do to protect our shoulders or maybe build up the strength? And I'm thinking particularly about people over say 50 years old and not being ageist, but let's be honest, we don't recover. I'm 37 and I don't recover like I did when I was in my twenties.
[00:17:49] Dr. Paul Cagle: So, a fun and somewhat unbelievable statistic for you. So, a group of my colleagues out of Wash U actually took people without shoulder pain, they basically took them off the street, so to speak. Put an ultrasound on their shoulder. At age 50, half of people have tears in their rotator cuff and 25 percent or half of those people have tears actually have a full thickness tear. Meaning part of the tendon is completely torn off. These are people without shoulder pain.
[00:18:14] Eric Knight: Woah
[00:18:14] Dr. Paul Cagle: So what that really means is that as we get past 50, many of us, at least one out of two, have some underlying wear and tear in our shoulder, even if it doesn't hurt. And so I think if you're going to work on a muscle group, the rotator cuff, which I think is a little easier to work in the gym, you can often do those with dumbbells or bands or cables, might be a place to focus. Particularly over age 50.
[00:18:39] Eric Knight: All right. Do you have a certain protocol? Do you have a YouTube channel that people can review of which kind of exercises to do?
[00:18:47] Dr. Paul Cagle: We do, I mean, I have, I keep some diagrams of them. But in general the most commonly torn one is the muscle on top. And you can really work that by simply just taking your hand, so imagine you have a weight in your arm, and it's sort of resting on your thigh. And just raising that straight up in front of you, so sort of like a front raise.
[00:19:06] That really does help hit that most commonly torn rotator cuff. The other, the other two would be if you imagine having your arm at your side, either rotating it in to touch your stomach, or rotating it away, so your arm is rotating away from your body with your arm at your side, really gets that internal and external rotation.
[00:19:26] Eric Knight: So that would be like, with a 90 degree elbow bend?
[00:19:29] Dr. Paul Cagle: Exactly right, and you could do that with a cable, you could do it with a dumbbell, but you got to be laying on your side, obviously. Or you could do it with a band. Um, I think all those, you know, those are kind of simple rotational and forward elevation strengthening exercises might go a long way towards some preventative rotator cuff injuries.
[00:19:46] Eric Knight: Right on. That would be very, very good. And it doesn't take a lot of weight to hurt a shoulder. I actually have a buddy who we lift with multiple times a week. He's in my group there and he had the weirdest thing happen. Except all of us said that's exactly how everyone gets hurt. Most injuries happen when you're like taking dishes out of the dishwasher or something innocuous.
[00:20:07] Like, I stepped off my front stoop weird. And I, you know, then I twisted my knee, or I woke up funny, or I slept weird. And those are the kind of injuries that seem to persist. Do you think that those happen from an underlying stress that we have put on these joints over time? Then that was like the straw that broke the camel's back or what?
[00:20:29] Dr. Paul Cagle: I'd say probably almost without question. You know, I mean, obviously you can step just right to where you could hurt a normal ankle or you could lift something just wrong to where you could hurt a normal shoulder. But I think most of those injuries are what you're suggesting, which is a shoulder, knee, hip, ankle, what have you, that's had a little bit of wear and tear. That, you know, maybe we don't notice. So we've been compensating for. And then you get something that just takes it just outside of that range where it can tolerate and cause an injury.
[00:20:58] Eric Knight: Yeah I would think so, because you'd have to have some underlying stress to make that happen. It doesn't just happen walking off a step.
[00:21:06] Eric Knight: Anyway, in the interest of your time, because I know... did you actually, you conducted a shoulder surgery just before recording this, didn't you?
[00:21:13] Dr. Paul Cagle: Haha, that is true, yes.
[00:21:15] Eric Knight: Oh my gosh, so how long ago did you finish?
[00:21:18] Dr. Paul Cagle: Uh, less than an hour.
[00:21:21] Eric Knight: Oh my gosh, how long was the procedure?
[00:21:22] Dr. Paul Cagle: Now, maybe, well, maybe when it's five, right now it's 5:30 Eastern time. A little more than an hour, maybe an hour and a half. Yeah.
[00:21:28] Eric Knight: You're still in your scrubs, aren't you?
[00:21:30] Dr. Paul Cagle: Oh, absolutely.
[00:21:31] Eric Knight: I love this much. Guys, listen, listeners, it is such an honor to have Paul on here because you do a lot of shoulder surgeries and you're one of the more renowned ones from my understanding. And you're in New York City? Which hospital are you in?
[00:21:43] Dr. Paul Cagle: Mount Mount Sinai in New York City.
[00:21:45] Eric Knight: Mount Sinai, that is awesome. I just have to ask... about how many shoulder surgeries do you do in a given week?
[00:21:51] Dr. Paul Cagle: Oh, let's see. This week will probably be 8 to 10.
[00:21:55] Eric Knight: That's way more than I would have thought. But I guess there's a lot of people who need shoulder operations.
[00:22:00] Dr. Paul Cagle: Yeah, it really, it does vary a little bit. I mean, obviously some of them take a bit longer. And if you have more of them that take a bit longer in a week, that would decrease the number. But I think that's a pretty reasonable number on average.
[00:22:11] Eric Knight: Are you doing most of them orthoscopically?
[00:22:13] Dr. Paul Cagle: Um, it's probably two thirds of them are, are done with the scope these days. And, um, the open procedures tend to be more joint replacements or nowadays they're more trauma. Obviously, as the weather gets warmer, people get out, unfortunately that does generate more patients.
[00:22:30] Eric Knight: Well, I was going to ask, uh, before getting to my last series of questions about brushing a pool. What are the most common injuries that you see that require surgery? And what I mean by that is... don't just say rotator tear. Like, what caused the rotator tear? That kind of thing. What kind of trauma or injuries or repetitive stress things put people in your office?
[00:22:53] Dr. Paul Cagle: The two most common soft tissue events are either a dislocation and that's often traumatic. I think we've probably all met someone who's had a dislocated shoulder. I was a repeat dislocator once in my life. It's no fun.
[00:23:09] Yeah, I'd say, you know, it's frustrating injury that I think we have good answers for, but nonetheless, it's a long rehab. And those can be either from sort of repetitive micro trauma. Meaning, you know, like yourself, you're taking your arms to an extreme range of motion for, you know, multiple cycles. And then eventually, you know, you get 1 that just pushes it a little too far and it dislocates. Or you can have your more traumatic style one where you fall down, your classic football style dislocation.
[00:23:38] For the slightly older crowd, which would be usually past you know, into your fifties, sixties, seventies, those tend to be more lifting event tendon tears. Really the two places that usually get folks, it's kind of like you're describing. They're doing an innocuous lifting event. I think one of the most frequent offenders nowadays is something like putting your bag in the overhead on a plane, and somebody bumps into you and your arm shifts and gets jerked back and things like that.
[00:24:05] But that can happen with a dinner plate. That can happen picking something out of a closet. You know, just those events where your arm is away from your body and you're lifting and yet, for whatever reason that gets pulled a little too hard or the wrong angle or just one too many times.
[00:24:19] I think those are really some of the most common ways people come in to these sort of soft tissue based injuries.
[00:24:24] Eric Knight: Wow. Yeah. None of them sound good. I've having personally torn my shoulder and having to get the surgery and the rehab as a competitive swimmer. That was tough. That was a really tough recovery and I don't suggest that anybody get to the point. I would say, see, well actually I'll ask you a recommendation.
[00:24:43] If you have a lot of shoulder pain, what should our listeners do so that they can heal themselves to the best of their ability so they don't have to get surgery?
[00:24:53] Dr. Paul Cagle: So the first thing to do is to keep it moving. So the shoulder is a funny joint where if you don't move it, it can get stiff. And if you get it stiff, that's really a second problem. Most people already have one issue with their shoulder. You definitely don't want two. So I think part one is just make sure you keep your flexibility.
[00:25:10] Number two is trying to avoid those inflammatory actions if you can. If keeping it moving and avoiding that gets rid of the pain over the next day, two weeks, three, I think you're okay. If you're starting to get, you know, more than one, two, three weeks of continual shoulder pain, it's probably worth going and seeing someone.
[00:25:30] It's usually not a very scary visit. You're probably going to start with some physical therapy and a majority of individuals can rehabilitate even partial tears in their shoulder and get back to normal function. I think it's when you kind of let them go for months on end and they get a bit more chronic that people sometimes have a harder time recovering.
[00:25:47] Eric Knight: Makes sense. Okay, last question about pool care. As a pool owner, and being in a lot of back yards, I understand that brushing a pool is actually a lot more physical than just about anything else. And that sounds silly because, you know, it's just a brush. You're pushing it down the wall of the pool, across the floor. What could go wrong?
[00:26:07] Well, you're constantly driving it down with force down the wall, and then you got to push it as it changes direction across the floor, and then you got to retract it. You've got to pull it all the way back and do it again. And I can absolutely see some injuries happening on that, and I know this, not just from my own experience, but from customers telling me that. that they have hurt their shoulders from this driving motion of taking this pole and forcing it down the wall in front of you.
[00:26:37] What could you say to that kind of injury? Or maybe if it's not an injury, it's repetitive stress. How can we brush a little bit safer to protect our shoulders and our backs?
[00:26:47] Dr. Paul Cagle: Yeah, I think it's really a two part answer. One, you're really describing a pretty hardcore shoulder activity, right? I mean, that's not easy for anybody regardless of their fitness level to be doing
[00:26:59] that sort of heavy duty, pulling pulling, and pushing kind of actions.
[00:27:03] Eric Knight: Right! I mean I break a sweat. I can vacuum my whole pool at a leisurely pace, no problem. I can net the pool no problem. I start brushing? It takes force. I've got to force my weight down with it, and I will break a sweat.
[00:27:13] Dr. Paul Cagle: I think when you're, you're doing those types of high level activities, you know, it probably is worth in your own time, and I realize that, you know, time is precious, but doing some type of regular exercise that does focus a little bit on your shoulder and your shoulder blade to keep those strong and in shape.
[00:27:32] Because I think that's, much like keeping good core strength, going to have some degree of preventative maintenance to it. So I think part one is just being honest with yourself and being saying, Hey, you know, I'm a heavy duty shoulder user. And that really falls in a bunch of different walks of life.
[00:27:48] I'll tell you the one no one really ever thinks about are hairdressers. So hairstylists, hairdressers, if you think about how they live their life, they live their entire life with their arms, basically at shoulder height.
[00:27:58] Eric Knight: Yeah, that's a good point.
[00:27:59] Dr. Paul Cagle: It's really hard on them. And so it doesn't seem like a hard, heavy duty career. But if you kept your arm, you know, basically 90 degrees away from your body the whole day, you'd be putting a lot of strain on your shoulder.
[00:28:11] So I think you look at yourself as someone who's a high level shoulder user or a high level shoulder athlete from this standpoint, and a little preventive maintenance is helpful.
[00:28:19] I think the second part of it, again, is doing it under control. I think where most people get into injuries is they got to get to the next job, they got to get to the next thing. They're in a little bit of a rush. You know, they let themselves kind of lean over, get in a bad position, push a little too hard, pull a little too hard. And I think that's where a lot of our injuries occur. And, you know, just having that presence of mind that like, maybe this one activity is the one to not, cut corners on form and cut corners on grip, but to really focus on your form and how you're standing. And. Now, if you've got to hustle doing it on sort of the other portions.
[00:28:52] Eric Knight: Right. Well, hey, I appreciate your time, Paul, I really do. And you heard it here first, Paul just said you guys are high shoulder users and an athlete in some regards. So pool owners and operators, you heard it from Dr. Paul Cagle, you might be an athlete and you didn't even know it.
[00:29:06] Paul, is there anything else you would like to say to us? Uh, Again, it's an audience of pool owners and operators, pool professionals and stuff. You have a swimming pool. You're about to renovate your pool. We've talked about this. Anything that you think about that pool people might need to know?
[00:29:22] Dr. Paul Cagle: I think the first thing you got to think about is there's so many things in the pool that are heavy. I think when you go out there, you got to remind yourself of that. The chemicals are heavy. Many of the activities are very heavy. You know, it's really not a light activity experience. So I think preparing yourself for that and coming in with that mindset that you give yourself enough time. And you have good form. It's probably the best way to go at this.
[00:29:45] Eric Knight: Alright, right on. Well we greatly appreciate your time. Do you have any other surgeries today?
[00:29:49] Dr. Paul Cagle: No, thankfully I'm done.
[00:29:50] Eric Knight: Ah, okay cool. Because it wouldI'd feel really bad if we were in between surgeries be I'd feel really bad if we were in between surgeries for you. Well, anyway, your time is valuable. Thank you so much, Dr. Paul Cagle, for joining the Rule Your Pool podcast. I don't know if it's official, but I'm pretty sure this was the low point in your career. So thank you very much.
[00:30:09] Dr. Paul Cagle: Oh, thank you so much for having me. I really appreciate it.
[00:30:10] Eric Knight: Everybody, this has been episode 145 of the Rule Your Pool podcast.
[00:30:15] If you have any questions, our help center is ask. orendatech. com and you can reach out if you have podcast suggestions. The email, as you know, is podcast@orendatech.com. We hope to have more awesome guests like Paul this summer. And they're not going to be about pool chemistry per se. They're going to be about you. Because we do care about you, and we want you to be able to Rule Your Pool.
[00:30:36] Thanks so much everybody. Take care.