In Season 2, Episode 15 of Alone with Peter we are joined by Doctor Dan Maggio. Dan is a board-certified physical therapist who has been practicing in the Phoenix Valley for over 4 years. As a strength and conditioning specialist, Dr. Dan works with barbell athletes and individuals searching to move past pain and improve their fitness lives.
If you are interested in following Dr. Dan Maggio you can find him on Instagram @DrDanMaggio, Anything talked about in this episode will be available in the show notes coming soon!
Dr. Dan Maggio – Board-certified Physical Therapist & Strength and Conditioning Specialist
Instagram: @DrDanMaggio
Email: [email protected]
Please enjoy part 1 of our interview with board-certified physical therapist Dr. Dan Maggio
*Transcripts may contain a few typos. With interviews ranging from 1-2 hours, it can be difficult to catch minor errors.
Peter Kersting:
Dan, I am really excited to have you on the show today. How are you doing, man?
Dr. Dan Maggio:
I’m good. I’m good. Thanks, Pete. This is awesome. Great to see you again and glad we get to chat about some things today.
Peter Kersting:
Yeah, dude. Well, so the older I get, the more I realize just how interconnected health and fitness are with everything in my life, my mental health, my productivity, and even my creativity. So I’m really excited to have you on the show to talk about some of these things because as a practicing physical therapist and a sports medicine guy, I think there’s a connection between all these things in a holistic sort of way that people maybe don’t necessarily think about.
Peter Kersting:
So in today’s episode, we are going to try to touch on Dan, the physical therapist, as well as Dan, the businessman. So if you’re ready, we’ll jump on in. We Mentioned before you’ve been practicing for a little over four years. What does your typical client look like?
Dr. Dan Maggio:
Yeah, right now in the current setting. We’re in an orthopedic, sports medicine setting, and really we take anything from seven to 97. So, our clinic doesn’t discriminate against the patients. It’s like, “Hey if you have pain, whether it’s your neck, your back, your hip, shoulders, knees, whatever, you know, come on in, we’ll treat you.” I’ve had patients with vertigo, dizziness, anything up to even fainting drop attacks. A lot of people don’t think that these are physical-therapy related and a lot of this stuff really comes back to muscles, nerves, bones, blood vessels, anything that I guess has that kind of origin to it. That’s what we could treat.
Peter Kersting:
Really? So something like vertigo has a physiological issue that can be like a muscular problem?
Dr. Dan Maggio:
Oh, definitely. A Hundred percent.
Peter Kersting:
So crazy.
Peter Kersting:
So what do you do? I’m just trying to imagine somebody comes in, like a seven-year-old comes in with what? Symptoms of vertigo? And they say, “Hey, doctor Dan I need physical therapy for vertigo.” In that situation, has that person been recommended to you? Or are you discovering like, oh, what you’re really dealing with is vertigo.
Dr. Dan Maggio:
Yeah. Really good question. I think both like it’s twofold. Right? So let’s unpack just one patient with vertigo and because if you have a seven-year-old, if I, if you’re coming in with vertigo, dizziness, that kind of thing, I’m gonna immediately assume you’ve had a concussion, you play soccer, some kind of sports, you’ve hit your head and that’s where the vertigo’s coming from. If you’re anyone else now we’re gonna screen out whether it’s related to your neck or whether it’s related to your ear. So inside your ear are these ducks or canals where fluid flows and in this fluid, it creates almost a gyroscopic effect and it lets your brain know where your body is at positionally. And if you’re able to maintain balance, right. So if those things are going outta whack, that’s where we can kind of fix that if it’s neck-related….
Peter Kersting:
I was just gonna say, it’s basically if the fluid levels in your brain are off, It’s gonna affect your balance. Is that what you’re saying? Or in your ear canal or something like that.
Dr. Dan Maggio:
In your ear, yeah. So with this fluid, there’s a whole bunch of physiology, parts that go along with it, but it, it more or less with the fluid and different particulates in the ear. It’s almost like if you, oh wow. I’m trying to think of a great analogy. Like if you have a cup with water, right. And you turn the cup, but the water still stays level, right? So inside your ear, there are these little rings that are filled with fluid. If I turn these rings, the fluid is still gonna try to stay level. And so as well as all the little particulates that are in it, these little particles, become crystals, they hit little nerve fibers that are sticking around the outside of these curves. And so when these crystals hit the curves, it kinda lets your body know, oh, I’m tilting this way.
Dr. Dan Maggio:
Or I’m tilting left and right. You know, if you’re watching the video, but sometimes that stuff can, yeah, you’re right. I’m sure hydration has, a part to play in it. Uh, I think a lot of people who are older who get this, I think they just don’t expose some of their body to these different ranges, whether that’s because their neck and their head just can’t go there. But it’s pretty interesting stuff. I’m not super well-versed in it. You can totally get extra certifications and more education. But yeah.
Peter Kersting:
I can’t imagine that that’s the most typical thing that you treat in physical therapy.
Dr. Dan Maggio:
Definitely not. That’s stuff’s super rare. And I’ll be honest. I, I think, you know, maybe once or twice a month, you’ll get a script that says, Hey, the patient has vertigo treat for vertigo and you do your assessment. And you’re like, I think what you, your dizziness and your nausea, what you think is vertigo is maybe not vertigo. Like a lot of it’s gonna come back to when I see that stuff, it’s gonna be the neck. Like I’ve had great results with treating the neck and then getting changes in the dizziness and even the spinning sensations. Um, just from a lot of the tie-ins of the nerves at like the sea, like your upper cervical level. So,
Peter Kersting:
I imagine that the average person coming to physical therapy, it’s maybe their second to last attempt to fix something. When somebody comes to you, how does their approach to therapy really meet up with how you’re trying to help them? I know I used to work in a hospital for example, and I could tell you when people are in the hospital, they don’t want to be in the hospital. It’s a very small percentage of the people that show up to a hospital that are there by choice. It’s because something happened and they have to deal with it and they don’t know how else to deal with it. Right? I imagine it’s kind of like that with you. So what are some of those challenges you’re running into with that?
Dr. Dan Maggio:
That’s a really good point that you bring up is physical therapy is not someone’s first thought when they experience pain. And I think that’s a really unfortunate thing because pain is, it’s a challenging topic to talk about. Um, but it’s even harder to then treat, right? Because now you have this complex experience that you’re going through. Um, does it have a really simple answer? Maybe? Maybe not, but I think with physical therapy being one of the last things that people see, it’s, it’s almost a last-ditch effort sometimes. Oh, I’ve had two or three surgeries. Oh, I’ve been to chiropractic two or three times. I’ve been over to this guy. and I’ve been to this neuromuscular specialist. I’ve been to this personal trainer. He said this thing. And so it’s almost like the people who physical therapy as a profession almost seems to be on this back burner. Oh, you go to them after you’ve had surgery and they’ll rehab you back to whatever you’ve had.
Peter Kersting:
Yeah.
Dr. Dan Maggio:
It’s really interesting. So that’s, that seems to be a really big struggle.
Peter Kersting:
The other day I called you. I have a friend who is a very active, very healthy guy who had hurt his shoulder. And he was concerned that he might have damaged his rotator cuff or something. And I, when he called me and told me about it, you know, there are all these different reasons why we’re talking about it, but one is that he does a lot of climbing for his livelihood and he climbs for fun. So obviously having an impaired shoulder is a big deal. He’s trying to figure out what to do. And so I said, well, you know, I don’t know what your course of action should be. I have no idea because I’m not, in any way professionally geared towards that thing. But I have this friend of mine, Dr. Dan, you should reach out to, and, and I remember when I called you, you immediately, and I think this speaks to your character and it’s the reason why I’m, I’m touching on this. You immediately thanked me for asking you to help my friend, which is not the typical response I would expect, but also you’re like anybody I can try to get them to stop doing surgery. I’m all in. Give me his phone. I wanna help him. So tell me about that.
Dr. Dan Maggio:
A hundred percent. Yeah. It’s one less person under the knife. One less person who has to do an extra medical intervention, I think. And this is now a little bit of my philosophy, right? Like as a society, I believe we have completely over-medicalized people. We look at this gold standard of Western medicine as being the pinnacle of health. Right? If we start to dive a little bit deeper, what we realize is that medicine exists on one of the pendulums to treat sickness, and health or healthcare is on the complete opposite end. Right? So once your physiology has gone so far to one side that’s where people are like, all right, I guess I should get this checked out my whatever. So if I can be somewhere to stop that pendulum from getting all the way over here. Let’s try to treat you before we experience a lot of that. I think taking a preventative approach is always best. Hey, and if it’s reactive and it’s, it’s like, let’s try to figure out what’s going on with the shoulder. Awesome.
Peter Kersting:
I’m glad you said the word reactive because that’s literally the word that was going through my head is like, do you take a preventative or proactive approach or do you take a reactive approach? And so I guess before we dive too deep into your philosophy, the last thing I wanna say about your current position is you’ve mentioned to me in the past that you have some frustration with how that position works. If you could touch on that, I imagine it has a lot to do with the attitude people have towards therapy. Why is it that you feel that’s the wrong way to think about it?
Dr. Dan Maggio:
Yeah, I think you hit on a very good word there by saying proactive and it’s even harder to be proactive in our super fast-paced world that we live in now. So everything seems to be reactive. Right? I only take care of my body when my shoulder hurts or when my back is really bad, then I take care of it. But there is an easier way. And that’s what we’re gonna talk about. Hope like later today.
Peter Kersting:
That’s exciting,
Dr. Dan Maggio:
As far as the experience that someone gets, when they go to a traditional therapy clinic, like, Hey, if you’re in and up in a PT clinic, awesome, good for you. You’re gonna get some good help. At the same time, I think it’s important to know, not all physical therapy is created equal. And if you go to one of those standard places that physicians recommend it’s gonna be more or less like…Hey, let’s just say my air conditioning in my house is broken, right? I’m not getting cold air outta my vents. So you get a guy who comes out and he’s paid by the hour, paid by the minute. And so he’s gonna take a look and he’s gonna be like, well, you know, I’ve got uh, 30 other houses to hit today and you’re like, hold on a second.
Dr. Dan Maggio:
You’ve got a 24 hour day probably only working like 10 hours of it. How are you hitting 30 houses? He’s like, well, you know, that’s my deal. I see that. You probably got a little leak here. I’m just gonna put a little duct tape around this vent tomorrow. I’ll come back. I’ll probably put a little bit more duct tape, see how your air’s doing. And then I’ll, you know, have a great day. I’ll see you later.The analogy’s not perfect, but in a lot of these clinics, the volume is so high that quite often the screening is not always the best. And so you’re left with just almost duct taping the solution and just finding like it’s symptom management instead of having a keen evaluation process. Right.
I was just listening to a PT that I really look up to in respect in the field. And it’s like, man, you have to really take your time with evaluating people and giving them exactly what they need. Then they don’t have to come back. Right? Like that’s the point is to give this person the real solution, spend the time necessary with that individual. And then you create someone who is independent in their own healing process. That’s the ideal situation right there.
Peter Kersting:
See that sounds really awesome because you’re empowering the client to not have to come back to you is it’s maybe in some ways that’s, um, a business model that sounds like you’re not gonna see as much work, but I can tell you from, okay. So I consider myself a pretty healthy person. I know I try really hard to pay attention to my diets and exercise a lot for both my mental health and physical. I’ve always had an attitude, when it comes to going to the doctor, for example, that’s been kind of negative because of the times that I have gone before. For one, I’ve worked with doctors. And unfortunately, my experience working with doctors is… it’s not universal but I felt doctors looked down at me because I wasn’t in the same position as them. That I was somehow less intelligent or didn’t understand what I was doing.
Peter Kersting:
And that’s on the professional level. Now in the limited interactions, I’ve had with doctors going in like you would think if you know that your clients, so to speak, don’t wanna be there. They’re worried about what’s gonna happen. They wanna fix whatever’s wrong with them. And, and it took a lot for them to come in there. You would think when they come to you and tell you, Hey, this is what I’ve got going on with me, that you would spend a little more time, making sure that you understand what they’re saying and make them feel heard. And also that, like, they put, probably know more about what’s going on with them than, than you do at least the big beginning. Right?
There’ve been times when I’ve gone to a doctor and they listen to the first few things I say, and they’re like, this is what we’re gonna do. And I’m like, hang on a second, bro. Hang on a second bro. Cause I’m the one who, I’m the one who’s paying you, dude. I, I’m not sure I wanna do that. Hold on.
Dr. Dan Maggio:
Yeah. Yeah. And it’s hard because, uh, I think for the most part people in the medical field, like they’re there to make a change and make a difference. The way that medicine is set up, at least in this country, I would say like just based on time, right? It’s not set up with the patient at the forefront.
Don’t just decide to live with chronic pain.
Peter Kersting:
Don’t just decide to live with chronic pain. I’ve done it and it’s miserable. It eats away at your soul. It’s so important to have a holistic approach to life. And what Dr. Dan’s doing is so meaningful because he’s putting the power back in your hands. You can do something as simple as follow him on Instagram @drdanmaggio, watch a few, one-minute reels for things like strengthening your shoulder, your back, your wrist, these things that in the daily grind start to weaken up, strengthen ’em and start to feel that pain melt away. Honestly, if any of this resonates with you, please gimme a follow on Instagram. And if you’re enjoying this podcast, follow me @alonwithpeter on Instagram. All right. Enough for me, that’s my call to action for the day. Follow Dan and follow Alone with Peter on Instagram. Now let’s get back to the show.
Dr. Dan Maggio:
The way that medicine is set up and least in this country, I would say like just based on time, right? It’s not set up with the patient at the forefront, right? Like the client always takes a backseat. It’s not a patient-centered approach. And I would say like, man, if for any of the listeners, right, if there’s an opportunity where you can look outside the traditional medical model, right? You go to urgent care, cool. You get your first extra is awesome. And you’re gonna go to wherever else. Right? But try to find someone who might, who still has those same credentials, but is practicing a little bit outside of the traditional practice. Man, you can have a way better human experience, right? Your results are gonna be personalized. And you’re probably gonna get your results a little bit faster because it’s not gonna be slowed down by the bureaucracy of insurance dealing with, I gotta talk to this guy. I talk to this guy, I talk to this one and they’re all not really even talking like I can’t tell you how many times man, you send off your notes of your evaluation of, Hey, this is what’s going on with this patient. Like I think you should take a look at this, this and this and that. You know, whoever’s on the other end, doesn’t have time doesn’t care doesn’t and like, so communication between providers even in healthcare is it’s hard for sure.
Peter Kersting:
The issue of healthcare as a whole is not necessarily what we’re trying to address on this topic, but I find it, it is a very frustrating experience. And so I wonder you mentioned volume, how much of that is the issue that cuz so you clearly want to spend time. You, you mentioned, you know, mentors saying you really have to spend time making sure you understand the, the problem before you start to prescribe. If that, if you will, I don’t know if that’s the right word. Yeah. Uh, how do you do that? Cuz I know you see a lot of people.
Dr. Dan Maggio:
I do. Yeah. In my current full-time setting it’s uh, on my long days, probably 10 hour days seeing man upwards of like 26, 27, even 30. I’ll have 30 people scheduled, maybe 27 show up in my half days, I’ll have maybe 17, 18 people scheduled maybe 15, 16 show up. Right? So there’s a little barrier of how many people drop off. But traditionally what you’ll find is maybe 15- or 30-minute blocks, maybe 15 for your follow-up visits and 30 for your evaluation. And I think that might seem like a lot of time for a lot of people. But when you get into it, our field is still a field of therapy. Right. There’s gonna be, and this is what we’ll talk about, right? With pain experience, there are the bio, the psycho, and the social approaches. Right? So all of those different ways of looking at pain, that’s what we’re trying to address in every session. And if it’s 15 minutes long, man, maybe I’m only hitting on like a small fraction of what’s really going on with a patient and then to give them a physical treatment, right? Like, Hey, if, if this type of pain is gonna respond to movement, which you know, most pain is, um, how am I getting effective movement across to that individual?
Peter Kersting:
Hmm. You mentioned there are the three areas, the bio, the psycho and
Dr. Dan Maggio:
The social
Peter Kersting:
Social,
Dr. Dan Maggio:
Yeah.
Peter Kersting:
Bio makes sense to me. Right. I have a physical issue. I hurt myself playing basketball. I hurt my knee playing basketball. Yeah.
Dr. Dan Maggio:
Let’s run with that example. Right. So like, let’s say you hurt your knee, playing basketball. The bio part of that example is what tissues specifically in your knee are hurting from the knee pain. Right? Sure. Um, is it a muscle? Is it a tendon? Is, is it the boney surfaces? What exactly is going on? And what’s the physiology related? Are you so swelling? Did you tear something cool? That’s the bio, the psycho part of it. Like the psyche is how I, as an athlete or as an individual are perceiving my pain, that’s going on in my knee. Like, oh my God. Like as soon as I, like, I landed, I think I tore something. Um, this is gonna put me out the rest of the season. Wow. Like, and so that aspect of pain can, or of the pain experience can make things a little bit more amplified, right?
Dr. Dan Maggio:
Because you come down in your knee, like, oh my gosh, I, you, you kind of expect the worst to happen. Right? You, you go Google your symptoms. I think I tore. Then it’s always worst-case scenario. That’s, that’s how our bodies have adapted over time. So our last one, so bio the psycho and then the social is, Hey, if this was how me as a basketball athlete if this is what I do in my past time, how I decompress after work. And, and my so social group is all of my athletes, all of the rest of my friends that I go play basketball with. How does me having knee pain affect my social life and how do the rest of my friends view me as having this knee pain. Right? So it’s, it’s more or less what I think about my pain and how the world and how I interact with the pain now going forth. Right. If I, if I’m playing basketball and I’m in the inner city, maybe I don’t have access to a PT or healthcare. That’s also a social aspect of knee pain.
Peter Kersting:
Dan that’s fascinating because we briefly mentioned the word holistic, but this is I think a pretty interesting illustration of how it really is holistic. Right. It almost seems like if I have a strong, negative, psychological reaction to the injury itself, is it fair to say that impacts my from that
Dr. Dan Maggio:
Oh, so much. Yeah.
Peter Kersting:
Also the social aspect, as you said, if it’s something, another example, maybe we dive into this in part three more, but let’s say I’m a digital nomad. I work on the go, I work a lot on my computer. My wrist is killing me, dude, from all the carpal tunnel I’m getting from all the time on the computer that is gonna affect the social aspect. This nagging injury. Is that the psychological? I’m assuming.
Dr. Dan Maggio:
Yeah, yeah. Yeah. Oh definitely. I think you nailed it on the head of, “Hey, my wrist hurts while I do my job,” But how does that affect, your brain’s gonna start thinking about how am I gonna provide for my family or myself if I can’t do my work with my hand? And then how do I interact with the world around me while my hand hurts? Going grocery shopping is gonna suck a little bit more if I’m going out in public and doing that, or I can’t hold on doors, or pull that stuff.
Peter Kersting:
You could just keep going. I mean, I think about, I spend several hours a day standing inside of a closet that is eight foot by six foot by 10 foot, maybe because I record voiceovers in that space. It’s very hot in there. And I’m standing the whole time that has a psychological effect on me because of the physical constraint that I place myself in. And because of the psychological effect, if I’m not careful, it could have a very harmful social effect in that. Like when I see my fiance, I might be really grumpy with her or whatever else. I dunno. It’s really necessarily the physical of no, totally. That’s what I think of immediately. It’s like,
Dr. Dan Maggio:
Yeah, I to, I can, I can really. Yeah.
Peter Kersting:
I love this stuff. I, I could go on and on and on with you about this. Okay. So we’re touching on all this stuff. I don’t think there’s any way you’re able to get this kind of in-depth with your clients in your current position. And I know you’ve mentioned you have some entrepreneurial goals, so is it safe to say that your current practice as a physical therapist in a more traditional role is a little different than what you ultimately want to do?
Dr. Dan Maggio:
That’s yeah, that’s definitely safe to say that. I think my goal with using PT as a way to experience life and I guess get what I want outta life. Right. Like being able to help people in the way that I wanna help them. Physical therapy was a path that I choose to say, like, I could, I could probably do this for fun and I really love helping people, but it’s gotta be on my terms. So yeah, I think right now, just trying to figure out what that looks like and, and make a plan and go forth with it. So,
Peter Kersting:
All right. So as we’re wrapping up this section, we’ve been talking with Dr. Dan Maggio about his philosophy on how to approach pain and manage it. We’ve been talking about his job as a physical therapist and the attitude that people have towards therapy. Dan, as we wrap up this set, I would love to hear from you, what was the catalyst for you to pursue physical therapy as a career?
Dr. Dan Maggio:
That’s a great question. I think it comes back to movement and I’ve, to me like sports were a, a big thing. And so I realized like, Hey, like just moving my body and being in the weight room was sometimes a little bit more fun than like playing basketball or, you know, going to play baseball. Like I really liked, um, the weight room aspects. And so looking at, uh, being a personal trainer through college, um, doing Olympic live, what weight lifting and working at different CrossFit gyms, I really liked being able to help the general population understand, like I can become strong, confident, and powerful in my body just by working out. And so that path took me into, Hey, how do I help these people who might be in pain while they do things like CrossFit or weight lifting or just lifting in the gym?
Dr. Dan Maggio:
Right? Like as I’m trying to better my health, I shouldn’t be experiencing pain. But what I realized was if we send these people out to go lift weights and go do these things in the gym and they have no guidance, it’s kinda like having a baby plan in the kitchen. They might get to the knife drawer. They might, you know, stab themselves with a fork. They may be taking a spoon into their eye. Right. And you’re like, no, that’s a, that’s a spoon. It’s a good tool, but the way you’re using it is wrong. And I think that part that’s what really, you know, gets me on fire to help people in this world of physical movement and exercise is the tools that we have to help work with people. Um, there’s no one that’s really showing people like how to use them and how to do it in a way where it’s, it sets you up for success for the rest of your life.
Peter Kersting:
I love it. Dr. Dan Maggio, joining us on Alone with Peter for the first part of our three-part interview, talking about empowering people to take ownership and control of their pain so that they can find the kind of improvement they want in their life. This has been a really fun interview so far. Stay on the lookout for part two dropping Monday at 7:00 AM Pacific time as we talk about Dan’s past, his current practice, and how that all ties into his entrepreneurial goals. Don’t miss another episode. Mash that subscribe button wherever you get podcasts and follow us on Instagram for updates @alonewithpeter.
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