Episode #43: Dr. Matthew DiPaola, MD | Understanding Post-operative Recommendations From a Surgeon Who Barbell Trains After Having Two Surgeries
WHY DO ORTHOPEDISTS SAY YOU CAN’T POWERLIFT OR BARBELL TRAIN AFTER INJURY OR SURGERY? WHY ARE THEIR POST-OPERATIVE PROTOCOLS THE WAY THAT THEY ARE? AND WHAT SHOULD A POWERLIFTER OR BARBELL TRAINEE EXPECT AFTER SURGERY?
Orthopedic surgeons often advise against barbell training and even suggest that their patients will “never be able to lift that again.” This comes from orthopedist’s lack of training and knowledge in exercise science and rehabilitation as well as trying to protect the surgical site from operative patients who may go “yolo.”
In this episode of the PRS Podcast, Clinical Coaches Drs. Rori Alter, PT and Alyssa Haveson, PT connect with PRS remote rehab coaching client, Dr. Matthew DiPaola, MD, orthopedic surgeon, who has utilized barbell training as his own form of rehabilitation and physical therapy after having two hip surgeries on the same side.
DR. MATTHEW DIPAOLA DISCUSSES:
Where post-op rehab protocols come from
Why they are designed the way they are
The role he feels the physical therapist plays in exercise and rehabilitation
How and why physical therapists can connect with surgeons
His own journey with hip surgeries and barbell training
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Dr. Matthew DiPaola, MD: [00:00:03]When they asked me like, you know, who should I see or, you know, should I go to somebody with your group or, you know, like, who's going to help me with such and such problem? I said, Well, you know, not only a doctor here, but I've tasted the cooking myself. So. Yeah, yeah, yeah.
Dr. Rori Alter, PT, PRSCC, SSC: [00:00:19] So, well, that's kind of where we wanted to interview you. So let's kind of just jump right into it because that is kind of a nice segue into why we wanted to speak with you. So one of the really cool things and actually I think when you first reach out, you had reached out to work with John, but at the time he wasn't taking on any clients. And so John was like, you know, you could speak with Rori, my wife, she's taking on clients right now. And I was like, Yeah, he's an orthopedic surgeon. This is going to be so much fun. So the cool thing about working with you is that you're not only someone who's gone through not just one, but two surgeries in the same area, but orthopedic surgeries, but you're also yourself an orthopedic surgeon. So we wanted to speak with you to kind of get. This hybrid viewpoint of the integration of barbell training into post-op orthopedic rehab for not just the high level athlete, but also the the, you know, kind of. Oh, the kind of generalized. No, that's okay. Generalized general strength athlete or strength trainee. So why don't you go ahead and just introduce yourself and tell us a little bit about your professional career as an orthopedic surgeon, what kind of people you treat, and anything exciting about your career that we don't know about, which we don't know about any like projects that you work on and stuff like that.
Dr. Matthew DiPaola, MD: [00:01:59] It's absolute pleasure to be on. And yeah, you're right. I originally reached out to your husband through Grant Broggi. Grant, shout out to Grant the Strength Co. I got to be friends with Grant online somewhere. Probably around the time I was kind of embarking on this whole journey, like 2018, 19, give or take, somewhere there and. And so, yeah. Guess I'll just start with who I am first. Dr. Matthew DiPaolo. Call me Matthew. Um, I am now in Buffalo, New York. I've been here for six and a half years, almost going on seven years. But I'm an orthopedic surgeon. I do specialize in shoulder and elbow surgery. Predominantly. I do, um, you name it. Um, the full gamut from fractures to instability, surgery to rotator cuff repair, elbow surgery, joint replacements in the shoulder and elbow. I also do some smaller amount of hand. I have other partners who do a lot more hand than I do, but I do a lot of basic hand, like carpal tunnels and trigger fingers and things like that. But really I love it. It's a wonderful specialty. Um. You really get to take people from, you know, having a real problem from start to finish and seeing them through and in all different age groups. I mean, I deal with people probably from teenage years all the way up into their 90 seconds. I don't I don't deal with some of the smaller kids because we have other partners who do that, its own specialty, pediatrics. But shoulders I love because and it was it was kind of an area that I happened upon when I was in residency. I originally had. I like spying also. And that's still an area I know I have a twin brother who does spying, so that kind of works out well. But, um, that's a I could get him on maybe for a different discussion.
Dr. Rori Alter, PT, PRSCC, SSC: [00:03:54] Oh, that would be so fun.
Dr. Matthew DiPaola, MD: [00:03:55] I know, but, um. No, I like that. I guess both had parallels. Both? There's a certain amount of complexity to them. Um, and I discovered the shoulder when I was in residency. Um, I felt like there were a lot of things I could kind of sink my teeth into. There was a lot to learn. There was a lot that was changing and it still is changing. There's a. One of the things that we've seen is a big evolution in arthroscopic techniques, development of arthroscopic techniques. Um, we've also seen a big revolution in what we call the reverse shoulder replacement, which is opened up a lot of treatments to for problems that maybe weren't solvable in the past. So, so those are things that are kind of active areas of interest in research but I just I find it a great field. It's, you know, probably for a lot of the same reasons you guys do where you're helping people become functional again. And that was always. You know, when people were are deciding what to do for medicine, we often kind of fall into stereotypes. You know, like I remember that I interviewed with a plastic surgeon when I was in medical school or getting into medical school, I should say, applying for medical school. And he said, Oh, you'll be perfect for orthopedics because I was an athlete. I played played football in college and multiple sports in high school and before. And I honestly wasn't leaning towards orthopedics then. I just knew I wanted to do some form of surgery. There was just this. The tactical, the. The technical aspect. The manual aspect. The. There's there's an. Element of sort of physical and intellectual at the same time that I knew was right for me. Um, so I kept it in the back of my head, but, but I did find myself gravitating towards fields that were function oriented. In other words, there are some fields where it's. Life and death. You know, we're saving lives. And for whatever reason, emotionally, I wasn't drawn to that. But emotionally, I was drawn more towards helping people function. Well, it sort of.
Dr. Matthew DiPaola, MD: [00:05:55] Can you live a better life? You know, it's one thing to live a longer life, but can you live a life of better function and just. You know, can you function well? So orthopedics was that was an easy sell from that regard. And it's been, I guess, my perspective from ever since. And I really feel like it's it's actually, um. I feel that even more so now than when I was interviewing again. I remember interviewing then into residency, and I felt that same pull of helping people improve function. And I feel like as I get moved farther along in my career, you learn more, you become more technically sound. I keep going back to that fundamental and feel prouder or more confident that I can actually help function or know when you can't. Also, it's probably important to note when you when you maybe can't do the. What you can and can't do. So yeah, that got me into orthopedics. In fact, I think back on these things because, you know, now you give it a little time to reflect on what people ask you. You know, I interview medical students and I interview residents in our program because we have we're part of a teaching program at the University of Buffalo. So we have sort of a mixed model where we have our own practice that runs just like any private practice. But then also we're part of the broader teaching institution At University of Buffalo. We have a residency where we teach five orthopedic residents every year, and I'm part of that. So I do a lot of teaching. So I reflect on these things relatively often, you know, because I'm helping guide some of these guys and girls who are kind of moving into their career too, and trying to decide and remember one of the. I had a couple interviewee or interviewers. I should say that when I was applying to residency, a few said, Oh, I really liked your personal statement. And it brings me back because remember I led off with saying I spent most of my original, most of my early life trying to avoid the orthopedic surgeon, and that was my lead into my essay.
Dr. Matthew DiPaola, MD: [00:08:06] And it sort of caught their attention. And it was the truth because going to a surgeon when you were, you know, playing sports meant you weren't going to play, that you were out, you were on the sideline. And I consider myself pretty lucky that in my career. So like I said, I played a few sports and just growing up, you know, high school and whatnot, but then eventually gravitated towards football. That was just my favorite and, you know, thankfully had enough. Skill and talent and hard work and whatnot to play at the college level and really loved it, enjoyed it. But I was fortunate, too, that I didn't sustain a lot of injuries. Then I had a few ankle sprains that one of them reared their head last year with some inflammation that I remember. Yeah, I told you about that. My partner looked at that for me. And it's funny because I found some surprises on my x ray. I thought, Holy cow, what happened there? But, you know, high.
Dr. Rori Alter, PT, PRSCC, SSC: [00:09:01] Ankle could lead us down a whole rabbit hole of that's a whole other you find on imaging. And does it, does it. No that's that's.
Dr. Matthew DiPaola, MD: [00:09:08] That's actually a great topic. I don't know how much you guys have talked about that stuff. Yeah.
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:09:14] A lot. A lot. Yeah. Yeah, we actually.
Dr. Rori Alter, PT, PRSCC, SSC: [00:09:17] Yeah, go ahead, Alyssa.
Dr. Alyssa Haveson, PT, PRSCC, CSCS: [00:09:19] I really love how passionate you are about function and the emphasis on function. And I guess it doesn't surprise me that you're so active and you participate in a very function oriented activity outside of your professional, you know, day to day work. And so we also know about you is that you are you're a barbell athlete and. I think that's really cool that you're doing what you do and you're a barbell athlete and we really want to get your perspective on where barbell training fits into to orthopedics and all of that. So can you tell us how long you've been barbell training and what your philosophies are about barbell training and injuries? And are your views about heavy lifting any different than those of the other surgeons or orthopedic surgeons that you practice with?