Hey everybody, welcome back to another episode of The Author Hour Podcast. As always, I’m your host, Gunnar Rogers and today, I am joined by the brilliant and the hard working and the very interesting Chuck Duff. He is the author of the brand-new book, Ending Pain: Coaching the Body with Neuroscience, Movement and Trigger Point Therapy. 

We have a really insightful and fun conversation about pain management and specifically the way his book and his methods treat pain versus how western medicine and specifically, even opioids treat medication and we have a really interesting talk about the future of pain relief and where we both, honestly, hope that it goes.

I hope you go pick up a copy but before you do, enjoy my conversation with author and all around amazing person, Chuck Duff.

All right everybody, as I said in the intro, I’m joined today by the brilliant, the intelligent and the amazing Chuck Duff, author of the brand-new book, Ending Pain: Coaching the Body with Neuroscience, Movement and Trigger Point Therapy. Chuck, thanks so much for joining me today.

Chuck Duff: Thank you, Gunnar. Glad to be here.

Gunnar Rogers: Super glad to have you. We’ve had some conversations in the past so as a runner, as an athlete, as a husband of a physical therapist, selfishly, I’m very excited to dive into your book and your work today. The book and your coaching the body method, hinge on a lot of eastern medicine practices, trigger point therapy, some fringe from just a not very known perspective methods. When did you first become aware of these practices?

Chuck Duff: Well, I started as a body worker in the late 90s. I trained in traditional Thai massage and you know, it’s a very cool discipline, a lot of movement, a lot of great techniques but just not—muscles don’t even exist in the traditional Thai system. So it’s a different system theoretically but the techniques are really good. So around 2001, I started, I was getting a lot of pain clients that I knew I had to get other tools and I discovered Clair Davis book just kind of popped out at me on a Borders bookshelf and I was amazed, you know? 

It was a map of X’s and where you feel pain and I had seen some of that. So, I got really excited and studied with Clair and that I dove into the source materials for a long time and just medical textbooks. From 2005, I taught my first course in the new modality but you know, of course, then, it was still a really being developed.

Gunnar Rogers: That’s insane and I do have to let the audience know, before Thai massage even, you were a software engineer by trade, correct?

Chuck Duff: That’s right. Yeah, I started a software company. So I got into this field because I wanted to, you know, just be around people more, help people and you know it was a good move except that now I’m still in front of a computer a lot, so cool.

Gunnar Rogers: Which is just about as much—and those pain clients that you were having, was it athletic related injuries or was it just chronic pain people? What was some of the pain that you were seeing in your clients?

Understanding Pain

Chuck Duff: You know, it’s all across the board. I was getting a lot of my yoga friends. I did yoga and martial arts a lot when I was younger and you know, just routine things for them. They were easy to work on because they had a structure and practice. Most people, just regular people may not necessarily be used to that but they have, you know, like one lady had, she was a pharmaceutical sales person, carrying this incredibly heavy cases and her shoulder had disjointed 30 times I think, before she saw me and you know, it was really just a muscular imbalance, the shoulders is a very delicate joint really requires balance in the rotator cuff.

So you know, it was things like that, it was across the board. I did work on athletes and dancers. They’re easier because they are very used to, their body is used to kind of self-repairing trigger points and they have great metabolic levels going on at the cellular levels. So you can trust that their vascularization is going to be able to recover more quickly, you know? 

Because trigger points are really just failures of metabolism at a cellular level and it starts to get some edema and then the nutrients don’t get out and ATP doesn’t get out and you know, that sort of starts the cascade and we’re always repairing trigger points but an athlete like yourself or you know, martial artist, yoga people, they’re used to just having that and so you know, they’re easy to work on the regular people that aren’t doing much.

Gunnar Rogers: Definitely and I’m also curious whether it was an athlete or even like, your pharmaceutical sales rep client, were people coming to you as sort of a last resort? Like, had they tried a few tried a few things first and they weren’t working, so they ended up with you? Just at what point along their pain relief journey were these people on when they finally found you?

Chuck Duff: Yeah. I mean, in the beginning, I really didn’t have a reputation as a pain person yet and so people would come to try the Thai body work just because they thought it might be good and yes, they – I mean, we routinely see people that had been you know, thorough 10, 20, or more practitioners and you know, that started really perking my interest because you know, it’s just, if that’s happening in my practice, it’s happening all over. 

It just means that what my conclusion ended up being is that, you know, the basic idea and understanding of the origins of pain was just off in the mainstream training and understanding. So that encouraged me to kind of you know, go more deeply into it.

Gunnar Rogers: Makes total sense and that, it makes me think of two questions about both parties involved here. So first off, what does the patient population, so just the general population, not understand about pain?

Chuck Duff: Well, you know, typically, your shoulder and to your shoulder hurts, you go to the doctor, they’ll say you have bursitis they may not even X ray or maybe they say you have a torn rotator cuff and maybe you do but you know, the learning here that was really critical for me is that A, most pain does not come from injury even if you have a verifiable imaging of a partial tear, let’s say in your supraspinatus tendon. 

The doctor’s going to say, “Well, we either need to have that repaired or that has to recover and that’s causing your pain” but it really isn’t. In fact, trigger points cause shortening of muscles. So you know, let’s say the supraspinatus muscle starts to bunch up, it has less room underneath the bone, the acromion and it starts rubbing in frame. So in a sense, it’s backwards, the muscle’s actually causing the tear and the pain, you know? 

So that was revolutionary when I first, you know, started reading about it and then I was putting the stuff into practice of just having more and more success. So you know, that was really satisfying.

Gunnar Rogers: Exactly and that’s what makes me wonder, you know, you’re seeing such a high rate of success with our patients and with these practices. So it makes me wonder on the medical side, in the medical community, why have practices like trigger point therapy been so marginalized?

Why Are Alternative Practices Marginalized?

Chuck Duff: Yeah, that’s a great question. Well, you know, Gerald Simons were MD’s, she was actually a—her dad was a cardiac surgeon and she worked in cardiology ward and you know, it was a different era. It was the 40s and 50s, they had more time. Doctors these days do not have an hour or 90 minutes to inject, much less the muscular anatomy all over the body, which you need and the primary modality was injecting procaine, you know, to break up the trigger point. 

So that wasn’t just accessible. Well, I called that trigger point 1.0 because it was you know, a monumental piece of work but they weren’t even really trying to bring it into the main stream. They came up with something that they thought would help doctors and it was actually an orthodontist, was and a dentist in general were one of the first groups because they inject already, they understand facial muscular anatomy and neck—

They have to and you know, they can weave that into their work, trigger points can easily mimic as a tooth problem. So they took it up and that was fine but the rest of the population, A, they didn’t have good manual therapy techniques. You know, it was just basically become just press on the trigger point and hold but you know in my system, we use a lot of movement and that’s the neuroscience aspect. 

So a lot of that just didn’t exist back then and a big part of the book I devote to A, how fantastic trigger point theory is and B, how poorly it was taken up and accepted and you know, it can be, I think, a very widely accepted practice but there needs to be different education around it.

Gunnar Rogers: Exactly. Well, it makes me, as I was preparing for this interview, it made me think a lot about, you know, Tom Brady. Still playing football and there’s been a lot said about his body coach, Andrew Guerrero, who uses a lot of trigger point therapy and a lot of “Chinese or Eastern Medicine” and that comes with a certain perception. For you as another practicer of this modalities, what is a misconception that people have about again, “eastern medicine”? 

Chuck Duff: Well, I think, Eastern medicine is, you know, some people accept it. I think a lot of the mainstream medical community just doesn’t understand it and you know, there are definitely, you know, the PT population now, I think more people are experimenting with it. It’s a very deep practice in itself, you know? It’s basically a PhD level of study just to be an acupuncturist.

I used to teach at Pacific College of Oriental Medicine. I taught in their oriental body work program. So that was where I sort of gained some knowledge about that, you know? But I think the real issue is that the stuff starts sounding like voodoo, you know, trigger points, they cause a weird referral somewhere else in your body, there’s no real physiological explanation for that yet. Oriental medicine, you know, you have energy lines running through the body. So a lot of people are just, in the west, are just not quite ready mentally to embrace those things.

Gunnar Rogers: And is it crazy to think, you know, we think we’re advanced and we’ve innovated on the western side but there are some of these principles and theories from the east that are maybe ancient but they still work today. Is that’s sort of, what’s it like to just see that in general?

Chuck Duff: Yeah, you know, I myself when I was 13, I had a tumor on my left clavicle and you know, I had a brilliant surgeon who had to reconnect some muscles and I’ve been normal, really, in my shoulder. So you know, that’s the brilliant part. We need those people and we need that knowledge. The problem comes, in pain, of basically the bottom line is, most people think is just from injury or disease and working with the stuff, you realize that you almost just whatever the diagnosis, you give it a try. 

Most of the time, you’re successful which then indicates, well, it wasn’t actually the thing that you were imaging because I didn’t change your labrum or fix your supraspinatus tendon, you know, but you feel better. The pain’s gone. So I was kind of unbelieving at the beginning because I started having some success and I was like, “Wow, I’m not even sure how that happened” you know? But it was only after I studied for a few years that I started to understand it.

Gunnar Rogers: Exactly and I’m also curious because we’ve talked about it in the past, you talked about it in the book, what role does the opioid epidemic play in our western version of how we manage pain? Like, how is that causing issues as well?

Role of the Opioid Epidemic

Chuck Duff: Well really, when you talk about the pain industry in the west, it’s primarily a pharmaceutical industry because, you know, pain practitioners, I’ve met a few, you know, it’s a 15-minute visit and they figure out how to modify your medication. Nobody’s really trying to get too the bottom of what’s causing the pain because the knowledge just isn’t really there and so there’s a very high incidents of people that start out on prescription opioids and then end up on street drugs because you got addicted, you know? 

Your prescription runs out and even somebody who really, you know, had no addiction history can end up at a very bad situation. We had a hundred thousand opioid deaths in 2020, which is the highest to date. So it’s been measured, you know? So it is getting worse.

Gunnar Rogers: I know we can’t solve all the world’s problems on this episode quite yet but I am wondering, just for your opinion and for a little bit of your expertise here. What will it take to shift our, you know, western civilization away from our reliance on opioids and these surface level types of fixes and move more toward trigger point therapy being a pretty widely accepted practice when it comes to relieving pain?

Chuck Duff: Right. Well, that’s really the reason why I wrote the book. You know, I as an individual have helped a lot of people, you know, in the hundreds, maybe in the thousands but that’s not going to change the world. You know, I teach students, I’ve got thousands of them out there practicing and that’s better but it really needs to be out there and A, people need to see clinical success.

You know, because you can—there’s all kinds of theories about everything and I’m a very skeptical person, you know? So I had to try all this and you know, we’ve come up with very repeatable ways of working with the common pain conditions. So my hope is that with the book, more people will get trained and start experimenting and realizing how well this works and we do get PTs and OTs, we’ve had MDs, RNs, massage therapists—

There’s a lot of interest in doing better with pain. You know, so I got to give people credit because it’s not in their basic framework, you know? But it’s going to be the clinical success and then what I’m hoping with the book is to kind of present why trigger point therapy was not accepted and then, some of the things we do to modify it that make it more successful, you know?

We use movement and we use a lot of neurological tricks because pain comes from the brain, you know, the brain assesses danger signals in the body, no susception, which trigger points produce. They mimic an injury in that regard because if you cut yourself, you’re going to have these no susceptive compounds and then it will flow to your brain and it will decide whether it’s serious enough. 

Pain is like the smoke alarm, it’s a way. So what we say in neuroscience is that pain is not inside out or outside in, it’s an output from the brain and you can have people in terrible 24/7 pain and there’s no discernible damage at that point in their lives. So you know, that’s what we really have to understand, that’s why I focus on the neuroscience part. 

I think Lorimer Mosely, a physiotherapist in Australia has done a terrific job. He’s got a great TED Talk and you know, you see things like that and it gets people thinking. So that’s what I’m trying to really do is open people’s minds a little bit.

Gunnar Rogers: Exactly and you know, speaking of opening lines and you mention, teaching other practitioners the coaching and the body method and you know, not just the method itself but the science behind it, the neuroscience, the anatomy behind it. When you’re teaching students, you’re coaching the body method, what is it like for you to see the lightbulb go off for them as far as like, understanding how useful and how helpful this is.

Chuck Duff: Oh it’s terrific, you know, and with the pandemic, we had to cut back and pretty much eliminate teaching for a while, we’re back into it but I just treasure, you know, that individual experience that you know, yeah, it’s exciting and then, you know, it may happen with them using the techniques on their own bodies or their clients and in terms of our online program, which has been you know, much more widely distributed especially over the pandemic. 

We do a yearlong training and it’s all virtual but then, we can read the comments and feedback of that, that’s just mind-blowing. You know, people will say, “You know, I’m on your third lesson, I’ve already helped three people with pain I couldn’t touch.” So that’s why I’m here, you know? That’s what excites me.

Gunnar Rogers: That’s awesome and are students ever coming to you skeptical or by the time they get to you, are they pretty bought into what you’re teaching?

Chuck Duff: Most are open but you know, anybody who has been to the degree, you’ve been traditionally trained, for example, in the medical system, you do have a healthy skepticism and they should. You know, they don’t need to drink the cool aid, they need to see you know, what, because one of the things we do in class that a lot of people don’t, you know, they’ll do demonstrations and video at a model. Well, the model doesn’t have a shoulder problem.

Gunnar Rogers: Yeah.

Chuck Duff: You’re not seeing a real, you know, I pick people in class that actually have a problem and there’s may videos in our system that yeah, it’s a class but it’s in a sense a real treatment. So people can see what can happen in a very short time, you know?

Gunnar Rogers: Yeah and then I’m wondering, on a personal level in your own practice, what’s been the single biggest transformation that you seen in one of your clients as far as daily pain, absolutely debilitating to like, moving and doing yoga or whatever it is. Like, what’s the biggest success story that you’ve gotten to play a part in?

Biggest Success Story

Chuck Duff: Well, I think one of them is I worked on a woman many years ago, lived in Hollywood, you know, very wealthy and she walked in with you know, a pain device trailing along. She is really one of these 24/7 people. She was desperate, I mean at that point, it was electronic implant. The next step would have been something that kept her system flowing with opioids and they would say basically your life is headed for a wheelchair, you know?

I was fairly new at that time and she gave me literally a stack of medical documents that was about a foot high, you know? That I am going to do an hour session on and arachnoiditis, she had had nine back surgeries. The statistics with back surgeries are very miserable and your success goes in half every time you had another surgery, that’s been documented by the surgeons themselves, you know? 

So I did what I do. I worked on her, it was primarily in her legs at that point and I worked on her gluteal muscles and the movement and you know, she was very, very skeptical and also she was very tender and it was hard for me to move her. At the end she said, “You know that one session changed me more than any manual therapist has ever done” and she had an 80% improvement in her pain. 

Now, this is a woman who has that stack of reasons, you know, why she could be feeling pain and I just touched her muscles and nobody else had done that, so you know? 

Gunnar Rogers: Yeah, I mean it is one of those things where it makes you excited because you’ve helped somebody but it also shows you how far we have to go as far as how we treat pain in the west. 

Chuck Duff: Oh yeah, I mean the closer you get to the realities of how pain is so-called treated, it’s really just masked, it’s not treated. It starts to become fairly depressing, you know, it’s sad because the stuff you know, it disturbs and ends lives. You know, once you are in the opioid track, that’s a tough place to be and the advantage when you can take the pain away very quickly, then you’ve got a better shot at the person, you know, getting off the opioids and trying to move again. 

When your hips hurt you don’t want to walk, you don’t want to exercise or feed or anything like that, you know? So you start an upward spiral instead of the downward spiral that inevitable occurs with serious pain, you know? 

Gunnar Rogers: Yeah, exactly and so you have the in-person classes teaching fellow practitioners, you have the online coaching the body method and now we have this book. It’s available now, everyone listening, it’s discounted to 99 cents so make sure you go pick up a copy but I’m wondering you know, with all the resources you already have out there to teach people what your methods and allow them to practice some, what made you decide to also add a book to the mix? 

Chuck Duff: Well, you know I think there are a lot of sort of separate individual modalities in the body work industry and in general health. You really need, you know, it isn’t enough to just say, “Oh that worked and you know, I will tell my friends” you have to change the mental outlook and the understanding of the true origins of pain. So you can only really do that on a book. I do and I work on clients. 

I am educating them too, I treat them just like students and that is actually part of their healing because pain is produced by the brain and if you kind of down regulate that central system where the brain isn’t so much on alert, they start to develop some hope, emotional hope that their pain could be better, that will start to reduce the pain right there. 

My friend, David Hanscom, is an ex-spinal surgeon and he left the profession because of this and now he works exclusively with this central down regulation of pain that comes from Dr. John Sarno and great success with chronic pain. The part I think that’s missing from that central down regulation strategy is the turning points are out in the periphery and they’re sending the brain signals. 

You know, nociceptive signals so it makes it much faster and much easier to address those trigger points while you’re doing the central down regulation but you know, just the feeling of empowerment that this therapist is tell me what he’s doing, he is teaching me that can just work wonders in actually getting rid of the pain. 

Gunnar Rogers: Exactly. I totally agree. I am not bluffing when I say I am believer in you, I am a believer in the coaching of the body method and so now that the book is out, definitely we want people to go pick up a copy and read it. Once people read the book Chuck, what is the next best step people can take? 

Chuck Duff: Well the easiest, we worked for many years on creating an online program because you know, it is a barrier if you have to travel to one of our locations. It gets expensive, people have to stay in a hotel or whatnot, so we have this membership. It’s a year of weekly lessons dealing with a lot of the muscles, the most significant muscles for the common pain conditions and then we also have a couple of self-care courses that apply these ideas. 

Not in as much depth, you know, we have a shoulder self-care course and a sciatica self-care course and we show them the common muscles that will produce problems and give them some techniques. So you know that’s the easiest, the in person study. We do have a few locations and I really want that to grow of course, so that is one of my motivations for the book is just to be able to spread out our in-person teaching a little bit and get more competent people out there. 

We actually have a directory now called Pain Hackers, that’s our sort of nickname for what we do, painhackers.org and that is a zip code directory of people that are achieving competency in the system. 

Gunnar Rogers: Oh that is an awesome resource, so definitely everyone should go check that out and then finally Chuck, like we said, the book is out, we want people to go get it, we want people to take next steps, for you personally, how can people once they read the book engage with you and where can people come and follow you? 

Chuck Duff: Well, I reply to every inquiry I get. We get a lot of people on our webinars who put in comments, we try to reply to all of them. You know, I have my—I’m [email protected] and you know it is not going to change unless you know, you sort of work on that one person at a time and you know, so yeah, I’m more than happy to speak with people and we have some really talented practitioners in other areas of the country as well. 

So it is about education in the beginning, you really, that’s what you need to get the person on board and you don’t want to argue with diagnosis. You just want to do something and hopefully give them some vast success and then they’re really motivated.

Gunnar Rogers: Awesome. Well Chuck, thank you so much for your time and more than that, thank you for all the work you’re doing to help people not just manage their pain but truly relieve and recover from their pain. Please keep doing what you are doing, keep teaching fellow practitioners. For everybody listening, once again, the book is available now on Amazon. The kindle version is discounted for one week only to 99 cents so make sure you go take advantage of that this week. Chuck, thank you once again for your time today. I really appreciate you sir. 

Chuck Duff: Thank you Gunnar and yeah, you’re very enlightened in this area because you are an athlete, you’ve studied a lot of these things and it is a delight to talk to you. 

Gunnar Rogers: Awesome, all right. Thank you all.