33. Rikke Johansen: From Athlete to Chiropractor - helping patients and athletes move better

Rikke's website: https://rikke.us/
Instagram: https://www.instagram.com/rikkechiro/
Facebook: https://www.facebook.com/RikkeChiropractic/
Text: (650) 484-0110
Email: hello@rikke.us

We discuss: 

•  Rikke's  athletic background: Handball 🤾🏼‍♀️, powerlifting & bodybuilding 💪 , triathlons, 🚴🏼‍♀️🏊🏼🏃🏼‍♀️
• 🇩🇰 A journey from Denmark to the USA 🇺🇸
• 👩🏼‍⚕️  Becoming a doctor of chiropractic
• ❓ How to find the right doctor for you
• 🗝️ Key to personal growth
• 🔉 Shockwave therapy
• 🧊 Cold plunge benefits and protocols
• 😴 Tips for rest and recovery
• 🥗 Tips about nutrition

Rikke has 30 years of experience in practice as a doctor of chiropractic. Rikke truly believes that nobody deserves to live in pain. She graduated from Palmer College of Chiropractic West in 1992, started practice in a large, sport-focused chiropractic clinic, and then established her individual practice in 1997.

Certified Chiropractic Sports Physician (CCSP)
Certified Strength and Conditioning Specialist (CSCS)
Diplomate American Chiropractic Board of Sports Physicians – board eligible
Diplomate American Chiropractic Board of Radiologists– board eligible

Rikke's private chiropractic practice consists of many elite athletes who require the most recent and effective health care for optimum performance. RiKKE® Chiropractic was conceptualized out of the recognition that health care, rehabilitation, and prevention require more than what traditional chiropractic and medical care can provide.

For ongoing rehabilitation to occur in patients dealing with musculoskeletal conditions, and for anyone wishing to avoid injuries or conquer chronic problems, it takes active participation, as well as having access to quality support services such as myofascial therapy, core strengthening, supervised rehabilitation as well as individualized guidance on nutritional supplementation.

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Transcript

Klara: Thank you for accepting my invitation. Super great to have you on my Grandson Journey podcast. How are you?

Rikke: I'm really good, thank you. And thank you for having me.

Klara: I know we've been talking about this for quite a while, and as I've been reflecting actually on our recent get-together with our goals this weekend and thinking about our conversation today, I was like, how amazing it is that I have such a driven group of girlfriends. And when I listened to even the stories that you shared this weekend, one thing that really struck me is your fearlessness. I think about someone living their life to their full potential, exploring and playing and experimenting. That's what I feel like is you or some of the amazing stories I've heard. So hopefully, we'll dive into some of those. But before we do, what do you want listeners to know about you?

Rikke: Like most of your other guests, I also didn't grow up in the US. I grew up in Denmark but left fairly early on after high school to be a nanny in the US. Fell in love with the sunshine and blue sky. Went back to Denmark and did a couple of years of med school as pre chiropractic to come back to college in the US. And came back here to go to college and, um, ended up getting married, getting a green card, and stayed. Never went back to Denmark, never did, and probably never will. I like it here. I like the outdoors. And it was always my dream to work with athletes, to be able to think a little bit outside of the box. I never really knew what chiropractic was going to bring for me. You are very limited as a chiropractor, and continuing education is always going to be something that gives you more tools to work with athletes.

Klara:  And that's another thing you do fantastically. You do so many extra curriculum activities other than chiropractor that translates to your own personal development, and you're generally a very curious person. And so there are so many new things you're always trying and exploring and experimenting.

Rikke: Yeah. I recently hosted 15, uh, 16 young students from my alma mater, from Palma College to Chiropractic. And it was great to see these young, fresh souls come in, and they want to learn, they want to see what it's like. And it's very different because I am very different. I realize that, like most chiropractors in that, I spend a lot of time with my patients. I probably charge a lot more than the average chiropractor. And it's just a different practice I have with continuing education. I have a lot of extra tools that I can use. And I opted a long time ago not to take all the HMO insurances that would then control my practice so I could continue to do chiropractic the way I want to, to actually use my education as a clinician, not just a technician.

Klara: And obviously, you have big clientele and people who love what you do. And I, uh, think price comes with quality, so you definitely get what you pay for.

Rikke: Like I explained to these young people, like, you start in the beginning, you will take anything that walks in the door. Then when you become an old fart 30 years into chiropractic, then it's like, I don't want to go down my list of patients and go, oh, that person is coming in. So you pick your patients, and it's better for the patient anyway that you actually enjoy being with them and taking care of them. It's a personal interest for both parties.

Klara: Yeah, I would say maybe I'm biased, but I've looked at it this way, especially with chiropractors, or probably any doctor for that matter. But I feel chiropractors specifically, personally, because I've done a lot of chiropractors in the past and, um, there's some procedures or kind of the way you adjust if you don't have the right chiropractor. And expertise. People can get really injured. So that was the one thing that I always do, extra due diligence. And I'd done so much research before I ended up with you, and you were recommended by everyone. I was like, okay, Rick, is it? There are probably a lot of people that haven't had as much heartbreak, their adjustments, or experience. What would you recommend them to look at?

Rikke:I wrote a whole chapter that I would give to my patients when they move somewhere else. What to look for in a chiropractor or ten reasons why you should fire your chiropractor. And a lot of my colleagues may not approve of my way of speaking out about that, but we're all different. One of my patients found me by simply saying, I'm going to find a chiropractor that has, uh, degrees of continuing education. And I'm not an athlete, but I want to be a sports chiropractor because this particular patient learned that you have to do a lot more continuing education. So that makes sense to me. I'm like, well, that's a good way of thinking. There's a job fair going on at my college this month, and I looked at the participants, and lo and behold, my profession has turned into all these franchises. And these are clinics that are franchises. I'm not going to mention any of the names, but when, uh, you look at the staff, they have more marketing personnel than they do have chiropractors. That should scare you a little bit, in my opinion. But those are the chiropractic places where you get a technician or a very young doctor that's learning. I also tell the young doctors, if you're not sure what you want to do, go work for one of those places. Get your hands and get a lot of practice because you may see 100 people a day or 50 a day. I don't even see that for a week. So very different. Right. But if you are only seeing a patient for a couple of minutes, it's a different story. You can do the chiropractic adjustment, but what are you then? You're a technician. You're not using your skills, true skills. I lost my train of thought. But, hey, sorry about that.

Klara:  No, that was perfect. It wasn't lost at all. I just want to go back a bit to your athletic experience because you have done so many different sports. So maybe if you can just go through all of your progression because you transitioned from one sport to another, and then how do you see that expertise and knowing how to move and drive and perform as an athlete, translate to the chiropractic care and what you do now?

Rikke:I was a handball player, and most Americans don't know what that is, but team handball is actually an Olympic sport. US, actually. Huh. They got a handball team here. It's like soccer with the hands. But I got injured as a young teenager, and before title nine or whatever that would call in Denmark, we just didn't take care of young ladies when we got hurt. Not a lot was expected. So, uh, a completely ligament-deficient knee was not something we took care of back then. So I got in the 80s and got into weightlifting after I couldn't do team sports anymore. And then I took that as far as I could and got strong in the weight room. And then I moved to the US. And then eventually got a bicycle, started racing bicycles, and then I learned to swim and started doing triathlons. Um, but always stuck with the weightlifting.

Klara: I do want to touch on that because doing weightlifting in the 80s that's still not very typical. I remember even back in the day, everybody could look up, it's public my information or birthday. Right. I was born in 1985. Even then, in the Czech Republic, like when you were growing up, and especially even in tennis, we don't really lift much like the lifting we had with tennis. It's kind of pathetic. It's not really lifting. It's, uh, more, uh, a rehab. A little bit of weight for the shoulder and a little bit of legs. And it's more for building some sort of, perhaps, flexibility than real strength. How was that time in the 80s, being a woman, going to a gym, lifting?

Rikke: For me, it was okay; we know a little bit about it. It was Jane Fonda, Arnold Schwarzenegger, and all that kind of stuff.  That became the thing we were looking at. And then, um, the gym opened, and I wanted to get in shape because I got a little fat.

Klara:  You and fat, I can't imagine. Was it exercise fat?

Rikke: It wasn't fat. It was just like not being an athlete anymore, not running and doing all the things I used to do. So I said, I'm going to start at the gym. So I got into the gym, I started all covered up, started lifting weights, and suddenly I was quite muscular. I was one of the very few women that did it back then. And it was in Denmark; it was all about lifting weights, taking a break, smoking a cigarette, finishing up your squat sets, going back in, having a coffee and another cigarette, finishing up, and then going to the tanning bed to get tan. Right. Because we didn't know so much back then. But then I moved to the US. Well, came over here to be a nanny, and oh, my goodness, it was like Arnold Schwarzenegger. It was California. It was muscle beach. It was like everything. All the women were lifting weights. I actually started competing while I was here as a 17-year-old or 18-year-old.

Klara:  And that was Europe, was it?

Speaker C: Or powerlifting and bodybuilding? Yeah, powerlifting. I mean, we were close to Russia, so all the boys in my gym were all doing steroids. They would, like, get it from the eastern block and do whatever they do, I saw it all happening around me, uh, because that's what they did. Even young teenagers don't need steroids or anything at all. But it was very interesting to see that. It was so awful. But we know a lot more about it now. And then, after coming back to Denmark, I actually competed in Denmark as well. And I remember standing there in the showers that were coed. I was a junior at the junior National Championship. And I saw all the seniors, all the senior women, and I'm like, It's time to go back to school. And that's when I said, I'm not going to take this bodybuilding thing any further. I'm going to go back to school. But I also always kept lifting.

Klara: And when you saw the woman, was it just unnatural? You could tell that they were progressing with their strength.

Rikke: No, it was very obvious that they were doing steroids. Let's just put it that way. Let's leave it at that. And I'm like, Whoa, I only read about that. I actually see it with my own two eyes now. So it was very interesting. But back then, they all knew they were doing it. And it was not really my thing ever. But weightlifting became part of my life because that's how I was able to function with a bad knee. So yeah, and then, um, coming to California and getting a bicycle and finding a new sport to attack, it was amazing. But it also taught me a lot about what it's like as a young person to be injured. Something that will change your path. Because I probably would have never ended up in the US. If it wasn't for my messed up knee. I would have probably been married with kids and a house and a dog. Like my brother probably coaching handball and probably been an engineer and not a chiropractor. Yeah, but things change. You start looking at things I'm like, that doesn't make sense, that I should just stop playing sports. And now, within these last 40 years, we now have something called sports medicine. We didn't back then, and now we have sports medicine, pediatric, geriatric, and sports medicine. We just know so much more about, uh, how important movement is and how that is life. M movement is life. And if we stop moving, it's all over. So even as we get older, we got to find a way to keep moving. We may have to change things around but got to keep moving. And that is my job, helping people move, stay active.

Klara:  What is your favorite sport now? Do you have a favorite one?

Rikke: I still like throwing big weights around, but probably the best meditation is my bicycle. I learned something today, a new trick. When you go to the gym nowadays, so as to not have your internal monologue take people apart while you're working out in focus. I put on my reading glasses when I go to the gym. That way, I can see my watch, and I can't see all the people around me. It's perfect. So I wear reading glasses, I can't see what's going on around me, but I can in my own little world.

Klara:  That's an interesting trick.

Rikke: Yeah.

Klara: Uh, one thing you mentioned, bike. There is something when I get on; usually, it's the air dying that I have in a garage. Or I sit on a rower, and I row for 25 or 30 minutes. And these workouts are okay, but I always have an internal monologue, so they serve a purpose for me to get clear about some of the things that happen during the day, but they don't completely shift me from the workday. So there's something that I've realized going back to tennis because you require so much focus and hand-eye coordination and the instant timing of the ball to where I actually feel more rested after tennis because that makes me turn off my head. Do you have a trick for that on the bike? I'm wondering. Maybe I'm just not doing it well.

Speaker C: 20 minutes is not enough.

Klara:  Yeah, you need to go I used.

Rikke: To go climb a hill, and when you're about 45 minutes into it, that's when everything becomes clear, and you get your best ideas, you solve all the big problems in the world, it comes clear to you. And you could essentially run for president. If I had been born here or not.

Klara:  I love it if you look back on your past, was handball your favorite?

Rikke: Well, that's so long ago. And that's a painful thing now because I couldn't do it. The last couple of times I played, I dislocated my knee. But I got into endurance sports, and that became like my place of solitude and place of my favorite introversion. But triathlon was also great for me, training for something and just being out there on your own going forward, not setting any records, but just going out there and pushing your own limits. But I think as you speak with any endurance athlete when you go out there and first you burn up all your glycogen, then you start like burning into your extra storage, and then you got a fueling, and then you have to rely on the next level and the next level of mental strength. Mhm, it's cool, but that gets a point for me. I'm too old for it now because I'm a little worn out, so we keep it a little shorter.

Klara:  So how did you then decide from all your athletic endeavors to pursue chiropractic education and become a chiropractor? Was that process and path for you?

Rikke: It started with my dad back in the 70s having pneumonia. I come from an engineering and accounting family, so chiropractors were quacks right in my family. But when my father finally, uh, needed to do something about his bad back, he was taken to a chiropractor that affixed him, and he was back playing soccer again and all that. And then, when my back became a problem, they took me to the chiropractor. And that worked. That became part of, like, maybe once or twice a year, you'd go to the chiropractor. And right before I went to the US. To be a nanny, I went to see my chiropractor, and I saw this little pamphlet that said, you too can become a chiropractor. And that kind of stuck in the back of my head. So as the young, smart ass, uh, a teenager in the US. Okay, now how about I just stay here, and I'll just ask my parents to send me some money, and then I'll just stay here in California and go to school, become a chiropractor because I can. And my parents, of course, say, no, we're not going to send your money when you live in Denmark where education is free. So I went back to Denmark and then used two years in med school in ordinance, uh, with the medical students to do it. But I decided not to go into engineering because I wanted to work with people. Not that I have great people skills. I fake it all the time. I kind of don't like people. I fake it all the time. But I love my patients. Right. I actually love going to work every day, even after 30 years. But how did I decide on chiropractic? I mean, it became even back then when I wrote my application to get into college over here. It became sports chiropractic back in the late 80s when we didn't even have sports medicine. But I described how I was going to have weights. I was going to have a small gym in my office. I was going to work with athletes. And that's kind of what I got. I mean, I'm downsized now to just me, but that's what I had all along.

Klara:  Yeah, that's actually interesting that you imagine it at that point, like late eighty s. And that's literally what you created. Um, when I come to your office, you have your weights, your kettle bells, you have some other things for exercising. Would you think that you pretty much created it? This goes a little bit more to the mindset. Like, what do you think about what you attract and what you create? Do you think that thought at that point sort of manifested because you put the active energy and effort into it?

Rikke: I guess I think my primary motivation back then was that I wanted to get the hell out of Denmark. So I'm like, how the hell do I get out of Denmark and get an education at the same time? So that's what I think it was. And kudos to my parents for saying, okay, we will sign on that loan you're going to take to actually go to a different country and have to pay for an education that would be free in Denmark. I mean, I could have stayed in Denmark and gotten my medical degree, but no. So my parents were pretty cool about that. But it did. When I go back and read that essay, I wrote out that I wanted to have this and that. So, yeah, I kind of created it. It's funny you asked because I never really thought about that, but that's kind of what I ended up with. I also tend to treat people exactly. Treat, as in chiropractic treatment and clinician duties. I treat the way I would want to be treated. So whenever I go to a doctor, I would expect them to have looked at my chart before I come in. I would expect them to actually spend a little time going over their notes before I come in so they actually know who I am and know what my problems are.

Klara: Yeah, I love that about you.

Rikke: And I actually do have a doctor. I have a doctor like that. She's awesome.

Klara: I bet it makes it hard to sometimes find the right doctor. You knowing all the effort and things that it takes. Finding somebody that does the same. They can be, for sure, a challenge. And, uh, one thing I do want to mention that I also love about your practice is how everything is digital. So there was another thing that pulled me in, because I hate texting or emailing with people and making calls to get scheduled. I was like, Just give me a website, and I schedule when I need to, and it's done. And so you were the first, I believe, doctor that I went online. I actually filled out everything online, and you didn't ask me for any additional papers when I came, because most of the time, even when you put in all the work and you fill it out, you come to an office, doctor office, and they make you fill out these papers. I already did this whole work online. Why are we doing this?

Rikke: Uh, if a doctor does that to me, I walk out right there from now. I mean, it's happened to me, too. And that is absolutely I've worked with younger doctors that were not that into it. They want to control their schedule. Oh, no, don't let anyone just make their appointments. I'm like, why not? These are my hours. If there's an opening, go ahead and schedule. And then you fill it out, uh, online, because then I don't have to read it. And then fill it into the computer, and then shred the paper so much easier that way. And it can be done. This was another thing I wanted to show the younger doctors. I'm like, It can be done. I don't have an assistant anymore. I manage everything online. I do my own billing and everything. So it can be done. It is probably more work than most young doctors want to do, and they're scared of it, and they shouldn't be. So yeah. If there are any chiropractors listening young chiropractors, I would love to find a hard working young chiropractor that I could hand it over to one day and then teach them how it can be done. If you're organized and use the artificial intelligence that's out there and the digital world yeah.

Klara: That is continue to grow, for sure. But I would think the most difficult part is probably just setting it up right. Getting the processes and kind of the digitalization of it. But once you invest in that initial time, it pretty much carries over and you're set up for the rest of the process. Right. And it saves time over the duration. It just pays for itself, probably. It does not need to respond to text messages and emails of people.

Rikke: Yeah. I think my patients will tell patients they refer, like, make sure you fill out your paperwork before you come in, otherwise she's not going to be happy.

Klara: Uh, I'm sure there's other people than athletes who are wired this way, but this is what I wonder and kind of reflect being an athlete and doing many different sports. I feel like one of the things that it train us is the understanding of time and prioritization and efficiency and effectiveness. Because you need to squeeze so many more things into a day and you always time managing from early on is really bred into you because you're shuffling so many different things schools, sports, even just that early on and many more as you grow through life. Do you think that is one of the things that stuck with you? It seems like you really run your practice that way and treasure your time and efficiency and effectiveness. So you transfer it over.

Rikke: Absolutely. And uh, most athletes that have managed the schedule of both school work and athleticism, they already understand and they're used to it. And you can make someone want that. So I absolutely agree with you.

Klara: Yeah. And this is actually it's funny thing because it can be positive, but on the other side, I also struggle with it because when you come to an environment or people who don't value that, it just can drive us crazy.

Rikke: Yeah.

Klara: Going back to Chiropractor, what do you look at when somebody walks into your door? What's kind of some of the first things you want to analyze and maybe share a little bit? How do you approach things?

Rikke: First of all, I always look at people not just in my office. I look at people when I'm having tea, I look at people on the beach, I look at people at the mall. You are analyzing all the time. That's what happens. You can't help it. Oh, yeah. That person definitely will lead a new hip within the next five to ten years. That person has no range of motion in their right ankle. Oh, that person definitely. Now, before I get sidetracked, I was invited by one of my Olympic athletes to a, uh, homecoming in Colorado, uh, right before COVID hit. And I got to sit back and look at all these people that came from all different sports. It was just great to sit and see the differences in all the different body types. But when people come into my office, obviously, I have already reviewed their records, so I know what they're there for. I know their background. There's a big difference in what you do to a 17-year-old and an 80-year-old and their preexisting conditions. Right. But typically to a chiropractor, someone comes in with a musculoskeletal problem, pain, or joint problem. But I always look at the way they move. Right. I have my idea about, and then they're general mannerisms, and they don't know they're being judged already whether they're going to be my patient or not. But I'm just kidding. But, uh, they come in, and then we go through what any doctor would do. And it's not what all chiropractors do, although we have the skills to do it. But you go through their past medical history, their vitals, and everything, and then we go into the movement patterns, from ankle range of motion to the squat movement to overhead movement, to see how they generally move. And from that, you extrapolate what you're going to look more specifically at and come up with a plan.

Klara:  Yeah, we have to make a date and go to the best place that comes to mind, Santana Row. We're going to grab a coffee and sit there. And I want to hear all the commentary because it's interesting. I have that to some degree, too. So I wonder if it's like the athletic mindset. You kind of look at people, and I probably don't see it, and not probably for sure don't see it from that angle. But when I look at somebody who runs, I judge runners a lot. So I wonder if this is something the efficiency and effectiveness and how much it is part of any sport. Like, if you want to be great, you need to know how to move effectively to achieve the goal, whatever sport it is, because that will help you exert less power or keep the energy for longer. Right. Yeah.

Rikke: I mean, you're creating a body where you have less resistance to your kinetic chain. I mean, we go into a sport I just had one of my Olympic swimmers that just left. I mean, do I want that person to run? No, they're not good runners because they're like flopsy and this and that. Right. And then you see a lot of tennis players; elite tennis players are slightly bowlegged because that creates an incredibly stable base where they're not going to sprain things. So we see people go into sports where they don't get injured and things they're good at. Right. We're going to gravitate to things we're good at, and where we don't get injured, so we don't break. Down. So you see funny patterns in where we end up. Like, if you're incredibly flexible, yeah, you gymnastics, stuff like that. And if you had different positioning of your different bones or structured in a different way, you're going to end up in sports where you're good and where you're not injured.

Klara: Yeah. And the second thing I wanted to comment, you mentioned the word judgment, and I think it sometimes, especially nowadays, comes with typically a negative connotation, but I actually think it's really positive, and especially for you, a chiropractor, you need to apply judgment to create the right care. I think that's really part of it and part of the right care.

Rikke: Yeah. It's what it's all about. It's how it all works together. And, uh, it sounds kind of lame, but that is what we do. I had a great discussion last night with a bunch of doctors that also do the, um, ecocultural shockwave treatment, which is a phenomenal way. It's big in Europe. We're so far behind in the US. But I've been sending people out for this treatment for the past, like, two decades, probably. And now I have the equipment myself, and now I have the great. I sat here last night and talked to probably 1015 other doctors that are from all over the country from Pts Orthos, the biological doctors that are doing injections and PRP, stem cell, that kind of stuff. There was a veterinarian there that also does the shock wave. So a lot of different perspectives as to how we use that. There was something that really stuck with me, was a doctor last night, so he sounded like an orthopedic surgeon, but he's actually a chiropractor naturopath, and he does injections all day under ultrasound, and he does shockwave. And I love the way he was describing how he pick and chooses his patients, because that's what I do. If you come here to me and expect me to fix you, if your BMI is over 30 and your a one C is up over eight, basic metabolic syndrome, that's everyone else's fault. I'm probably not the right doctor for you, because I'm going to fail if I start working on you, because you are not going to heal, because you're not letting your body heal. So you go talk to a nutritionist, go back to your doctor, lose some weight, take the load off, and then take care of yourself. I'm not going to take patients. I'm not going to get better. And I don't really want to hand hold someone that needs something so much bigger than me. So you get to pick and choose a little bit. I'm totally off track again here, but hey, no, you're not.

Klara:  That totally connects that. It also drives on the efficiency and effectiveness and valuing your time, because you only have that much time in the day to help the people that really need to be helped. And it's just so understandable, because you come from that athletic background, you obviously want to help athletes and people who want to continue to be active, to move better. That seems to be really the mission and the core of who you are as a human. We should prioritize what we want to invest our time and energy into, especially even, like, a job.

Rikke: Yeah. To give an example, when early on in my career, I was always studying something, and I had a lot of my colleagues that were kind of like, why are you wasting your time doing that? You're not going to make more money. No, but I want to know more. I would get bored. So I became, uh, what we call a qualified medical evaluator for workers' compensation cases. And English is my third language. Right. So oh, writing. I hate it. You probably know what I'm talking about. So you would evaluate workers' compensation, meaning people that are hurt at work. And m, I ran into something I didn't know. You actually run into people that don't want to get better. I'm like, what? To me, that was like, whoa. But there are people that don't want to get better. They just want payment and a diagnosis, and then they want to be felt sorry for. And I cannot connect with people like that, to your point. Right. I'm also in an area here where I generally have people, um, that are motivated, intelligent, and know what they want.

Klara: And you're certainly stimulating, which is why we're here and talking about things. Because every time I come to you, we talk about all the fun things I study or I'm curious about, like food, nutrition, recovery, and maximizing human potential on all fronts.

Rikke: You talked earlier about all the crazy stuff I do. I'm like, Wait a second, wasn't it you that dragged me up, Half Dome?

Klara: That was so fun.

Rikke: No, it wasn't. I'm scared of heights.

Klara:  And you still did it. And with your knee, it was impressive. And it was so much fun. Just something about struggling together, trying to get up a mountain as a group.

Rikke: Yeah. You were not struggling, young lady. You were doing loops around us.

Klara:  Thanks. I felt good. I think, at that point. It's actually weird. Up the hill is not the hard part for me. The worst part is when you start going down and about, like, halfway down, the knees and ankles and the hips, they start really hurting from the downhill. That's actually the hardest part to get over. So I think my pain wasn't on the up-the-hill session. It was usually the last 3 miles or so.

Rikke: Uh, you've been out there all day, right? So it was great because I spent a lot of the day, like, just hiking by myself. It was fantastic.

Klara: Speaking about ways to decompress and think about different things. But I do want to go back a little bit to what you mentioned, and I forget how it's called the new treatment for the deep tissue because I remember you coming over to even our house for dinner and talking about it, and I can sense how excited you were and how curious you were about it. So a lot of people probably don't know what it is. So maybe you can describe it deeper and explain what makes you so enthusiastic and curious about it.

Rikke: Now, in the sports medicine world, I started hearing about it probably almost 20 years ago. Pisa wave is, ah, an acoustic wave that is focused on a very specific point. You can control the depth at where you are applying the therapy, but it was also being used for lithotripsy, which is breaking up kidney stones. So it's a very specific way of basically creating damage in the tissues to speed up the healing process in the body. But I heard about it a long time ago, and I had some patients that were having problems with plantar fascia. And I found a doctor over in the East Bay from here, and back then, they were doing it under anesthesia, and it was like when people couldn't handle some of that. Very deep tissue techniques I use, such as the grasping technique, which is instrument-assisted soft tissue work. I would send them over there, and I've been in the or. When they would put people under and then put this shockwave sound. Not a shock; it's called a shockwave. But it's really a very controlled acoustic wave that is changing things down at the cellular level. So they would have that done, and it would work. And then later on, a lot of the other doctors started having machines that would go into the office. You could do it without anesthesia. You can control the intensity and get patient feedback. So in Europe, it's huge. Now I finally last year decided to add that as a tool to my practice. So it's just great to have one more thing you can do. It's a way to work on tendinopathies like tennis elbow, plantar fascia, hip, uh, and bursitis. It is amazing for healing stress fractures in feet, but we get athletes back to performance after a stress fracture a month faster. It's four weeks earlier. So it's huge in that community of runners and on-feet athletes. So it's a great thing. Whenever there's someone asked if it would help that, well, let me go on PubMed and find out. And then you find all the research and treatment protocols; it's all there. And then a great community here that's being created by people that are promoting it. Uh, it's exciting. It's another tool to have in my little bag.

Klara:  Yeah. How many sessions do you think a person typically needs to have? Is there a recommendation, or does it depend on what you're treating and how bad it is?

Rikke: There are protocols, right? In my world of chiropractic, there are the chiropractors like me who say most things should be better in three to six visits. Right. And that's kind of how it goes if you're going to get better. And then there's a chiropractor that thinks you should be coming in all the time. And I don't understand how anyone had time for that. So three to six visits, sometimes it is six to twelve visits. Some of the acute injuries, you feel better after one, but the chronic stuff, uh, you go in there and one to two weeks into treatment, you start new vascular tissue is developing, so you're speeding up healing stem cell overturn and basically increase in the healing. So it's just a tool. Do the same thing with, um, the manual therapy and the instrument stuff, but the pipes away it goes where my fingers and my instruments can't go to a specific depth. I also use ultrasound to find out exactly where is the tissue I need to get to so I can measure diagnostic ultrasound so I can really be specific about the treatment.

Klara: Yeah. Isn't it amazing? What comes to mind is the advancement of science that has happened.

Rikke: If only we had that went back when I was an athlete. Yeah.

Klara:  I was wondering if you ever wonder because you're really on edge trying to deploy all the new things, and you're so into learning and development and exploring and studying pretty much all the things from diet, fasting, cold, blanche, and the tips to improve performance. Do you ever wonder what athlete you could be if you only had the same amount of wisdom and care back in the day?

Rikke: Looking at myself, I mean, I could have been mediocre. That's about it. I mean, it's amazing when you go out and play or train with someone that's truly talented and genetically talented. Right. I used to go riding with a, ah, professional cyclist. It was fine during the off-season. And then came spring, and he would turn on what I jokingly, uh, would say he turned on this gene that I just did not have. I could be a good all-round athlete, but I don't have what it would take to go all into something. I mean, it's just probably stronger than most. But it would have been great to have the right care for my knee back when I was a teenager because nowadays, they will go in and repair the ligaments. Right. Back then, they didn't. But hey, you can't go back in the past; you can only look forward. Right?

Klara: Yeah. What other things do we want to dive into? Ricky? I have a phlebotomy. That's another thing that you in and study.

Rikke: I'm also an EMT. I'm not an active EMT, meaning I don't ride around on ambulances, but I maintain my EMT credentials. Emergency medical technician. And that's probably one of the hardest things to maintain because it's a lot of hours, but then it's more for volunteer work. I mean, it came in very handy during the beginning of COVID because, with an EMT, they would let me go in and do volunteer work, like take out trash and stuff at the hospitals that were busy. And lobotomy is another thing I did because there was a shortage. I was bored during COVID, basically. So I was able to become a phlebotomist. So I teach it every now and.

Klara: Then I should describe what does phlebotomy mean for phlebotomy?

Rikke: Is not blood drawing venipuncture, so needles.

Klara: So you just decided, well, I have extra time on my hands. What are my good ideas? And that's what you came up with? I love it.

Rikke: There was a shortage, so you never know, right? It's good to have options. Like I always say to the young kids, keep improving your skills, and the more skills you have, when you start, it's almost like it all fits together, like studying thyroid lobotomy. You study the tests you do, and as a doctor, you understand the problems you have with it. So it all starts mixing together and everything gets easier.

Klara:  Yeah, it sounds like learning languages because you mentioned what was your second language.

Rikke: German.

Klara:  It seems like the more languages you speak, the easier it is to pick up the next one or understand the context of different cultures.

Rikke: Absolutely.

Klara:  Because if you understand the structure of the language, there's understanding a little bit of how the culture communicates and works and what is and isn't acceptable. Right. So it seems like in the medical field, or all knowledge for that matter, it's additive and even different things that you look at, then it all adds up together. If you do things that you're genuinely curious and passionate about, there will be some way in the future; all add up. 

Rikke:  Right out of school. Any doctor, it's all about learning. The more experienced you are, the more your brain is connecting the dots. You don't have that as a young doctor. So you learn in school, you learn algorithms, you learn to examine, evaluate, move, step forward. You have a pathway you follow. The more experience you get, the easier it gets. Right.

Klara:  What else do you want to dive into? Cold plunging. I know you do that now regularly and you've done a lot of your own personal reading and research on it. You have a practice on cold plunging. Would you recommend it to general people or even athletes? And what is your protocol?

Rikke:  It all started in 2021. I was out hiking with a backpack for the first time. I was in over my head, and the only thing that saved me every night was jumping in the river and just cooling down. It was still COVID, so we had all this extra time on hand. So I started reading the MHOF stuff and the research about it, and just feels so good when you get into a cold plunge, like at the spa or something like that. And then I said, okay, I'm going to see if there's a way I can afford one, so I got one. And then I said, okay, well, I'm going to send it to the coldest temperature, and then why not, right? I'm going to get to that anyway. So you kind of build your way up to it, but what strikes you the most is that, okay, so you feel good when your body's worn out and everything's hurting, but it is the change in your neurotransmitters. Your mood elevates your focus dials in, and it works every single morning. It's amazing. So you have that, and some stretching and a little hot tubbing is part of the morning, um, ritual.

Klara:  Do you have a hot tub, too, then? So do you go from the cold lunch to warm up to a hot tub for a while?

Rikke: Then you talk to people, and I spurred out some profanities when you talked about, oh, what about the thing that you go in the cold pledge, and then you can't build muscle? I'm like, my point to you was, okay, I mean, there may be some points with that, but unless you're really going for Mr. Or, uh, Mrs. Olympia and you're trying to build mass and stuff like that, we have so much research going on in that realm right now. So you've kind of found what works for you. Some colleagues of mine just got their own coal plunge, and, um, they're working their way up in the minutes of cold plunging. And there's so much good stuff that comes out of it all the time. Just read what Huberman has to say about it.

Klara:  Yes, I've listened to a number of his podcasts about how to use heat and cooling. And how many minutes did you start at, and where are you now?

Rikke:  We know that the maximum benefit comes in around two minutes. I worked my way up to that, and I remember the first time I did four minutes, I got out and run, like, I don't feel so good. That was too much. Okay. But now I can easily sit there for eight minutes in 39-degree water. But I do a little setting that's on Garmin for breathing. It's five minutes and 34 seconds. That's my go-to every morning. And then I extend it if I feel like it. And then some days I can feel my heart rate really come down. And it's just interesting how stress and your sleep levels will affect your heart rate through a session during the summer when I'm typically a little leaner than I am right now; it's no easier, no harder. So it's really all about your mindset and how you control your mind. Uh, it was very interesting on these very cold mornings when it's frosty and it's crispy because I just get up in the morning and hose myself down with a garden hose that's also very cold in the morning.

Klara:  Yes.

Rikke:  And then you just say no, it's just what I'm going to do. You make a decision, and this is not my line. Someone said that online, I heard somewhere. I'm like, no, I'm going to cold lunch because I'm looking at my calendar right here. And you know what? Weakness is not on my schedule today. You just go do it. Yeah, it's just not on my schedule. So I'm just going to go do it. And it's five minutes. Anyone can do that, right? All the motivation and M, I have to tell you, I don't like to be too hot or too cold ever. But cold punching is what I do. It's like, yeah, I'm going to do that extra set, or I'm going to run that extra mile. It's just what I do.

Klara:  What do you have it set at now? What's your temperature?

Rikke: 39 degrees Fahrenheit. It's 4.4 degrees Celsius.

Klara:  Okay. And this is an internal joke many people may not understand. Do you wear socks when you go in?

Rikke:  Uh, no, I don't. You should see what's up above my cold plunge. It says cereal chiller.

Klara: I love it.

Rikke: And then next to it says, get naked.

Klara: I may need to go get a test drive. I want to try it before I go and order mine. I was actually doing the cold showers in the morning for a while, but what I realized, it has gotten so much easier day after day. I don't think I was getting enough shock to where I felt like I was struggling.

Rikke:  It's not about a shock because you can control that with your mind as well. If anyone saw me do this right now, they're going to think I'm doing this in lukewarm water. And I do it every morning. It's like even on frosty mornings when hail is coming down, I am sitting down, and it is all mind control. And that is, to me, so fascinating. Me, I don't like being cold, but I can have a cold plunge. I walk around naked in my backyard there in the morning. And it's a mind exercise more than anything. And then the benefits of it because, you know, you're reaping an amazing benefit of just feeling great focus, elevated mood. It is fascinating.

Klara: I, um, look forward to testing it out. The next thing that comes top of mind is diet. I guess the one thing to introduce a little bit more is you and I often talked about the keto diet or Paleo diet fasting. You do intermittent fasting. And there's been quite a bit also the counter-argument, especially for women, that keto is more tested for men like fasting is more valid for the male body. It's not as good, perhaps for women. And so you're like the one woman I really resonated with and agree. And I feel like we have that mindset to eat protein first. How do you look at that? What would you recommend for athletes or maybe the general population? How do you look at it differently?

Rikke: I've done it all. I was vegan, vegetarian, and vegan for 28 years. Until one day, I was driving home from work, and I'm like, I want a steak. And I was doing bodybuilding as a vegan. I mean, you can do a lot when you're younger, and if you know what diet it's supposed to contain if you know your macronutrients, most people don't reel me in if I lose my train of thought because I have a lot of things to say about it. Although I'm not an expert in any way, right? But I've done it all, I've tried it all, I took go keto, and it's great because now you don't have all the carbs that make you puffy, and it's great because you always feel full, and you never have that hunger, and you can control your blood sugar. Same with intermittent fasting. But coming from being a vegan into eating some meat again, I don't eat a lot and when I eat it, it's good stuff. When people say oh well, I'm gluten intolerant well, then just eat vegetables and meat, don't eat processed food. It's not that hard. I have family members, and I hope they never see this because, I mean, they're idiotic in the way they eat, right? They stuff themselves with sugar, but it's gluten-free. I'm like, okay, you want me to tell you why you're getting fat? M. Okay. And then I have all the girlfriends that are my age past menopause and complaining about how they can't lose weight because it's menopause. No, it's that you're eating shit. And you are not building muscle; you're losing muscle. Muscle is the major organ that will burn fat and maintain your metabolism, right? And it's also what will help you control your insulin so you're not getting all these problems. So probably don't ever post that anyway; what I just said right there. Because people will be kind of, but intermittent fasting is great after COVID, I'm like, well, I'm just going to work through lunch. I'll eat from two to seven. That's it. And it's so freaking easy, right? Not wasting all this time eating. I feel incredibly sharp when I do that. Beginning of last year, I decided to see if I could gain ten pounds of muscle. And by lifting weights consistently and writing out the program, it took me about eight months to gain ten pounds of muscle. And that is coming from a DEXA scan, right? And to do that, you have to eat consistently. You have to fuel your body so it will build muscle. And I did, and it was weird eating every 2 hours again like I haven't done, and I gained weight in the beginning. And then you create an engine that can burn the fat. It was very interesting as a 56-year-old woman to do that. And yeah, it can be done. Check.

Klara:  What is your diet look like then? Did you carve out more?

Rikke: Not too much more, but more, yeah, you got to get the energy. So you actually feel like working out twice a day. Like, one of my favorite breakfasts right now is breakfast tago with an almond tortilla and eggs and spinach and bell pepper and avocado. It's just so good. I still love getting that every morning. And then I don't like to eat a big lunch because I am working bending over people all day long and lifting. And then, um, a relatively good dinner with just good protein and good colorful things. Often if someone really wants to do a little change, the Mediterranean diet is kind of good for a lot of people. It'll get them away from processed food. And it's not my favorite personally, but I can eat it. I know you guys used to be all fat and protein.

Klara: Yeah, with a strict keto. Even with the keto module measuring, which Trevor is way better in getting into ketosis, I've actually never figured out my optimal percentage because it takes a while and everybody's slightly different of the fat versus protein and how much of that you need to eat in different variances to really maximize your ketosis and get to a high level of ketones. This is what I've kind of discovered for being an average human, which would I rate myself now because I really don't have time to work out every day. Um, I work out every day, but I don't work out like four or 6 hours like I did. Right. So my workouts are focused on effectiveness and efficiency, between 20 to 40 minutes probably max, depending on how tired I am and how I feel. And then most of it is being by my computer, standing, sitting down. And so for that, I actually think I do very well on keto. So I think keto is really good for average exhaustion anywhere. So I use my Apple Watch. So I kind of look at when I'm burning between 500 that is on the minimum that I don't do anything free day to about 1000 calories, move calories. That's where I'm optimal on keto. When I start adding more, let's say, like tennis in exhaustion and long matches where I burn somewhere in the range of, like, 2000, I naturally start craving more carbs. Like, I need a little bit of ice cream or pasta after my match, or my body just starts craving these. So I've actually allowed myself to recover. Otherwise, um, I think more than anything, the body would be okay, but moody and just worn out. So that's what I'm craving to refuel.

Rikke: There's a fine line there, too. I mean, going into ketosis is not the optimal way for the body to work. Although there's research out there that people say, oh, it's the only way. I'm like, no, it's really not. Humans are omnivores, and we're all going to find what works better for us. Right? I had a bodybuilder the other day that came from being like this big puffy guy to suddenly toning down with a program from his coach on how to get lean, right? And it was amazing, the transformation. He looked from being a round puffy guy to a ripped athlete. Right. And now he never ever wants to be that fat again. So he's, like, keeping it. And he's learned that whatever my coach is telling me as far as carbs, I eat half of that because otherwise, I get puffy. So we all need to find out what works for us. We all know that sugar becomes an addiction. Whenever I cut out carbs, I crave sourdough bread and brown rice. I don't know why that is, but that's sugar, right? So the body doesn't care if, uh, it's a Coca-Cola or green drink. It's sugar.

Klara:  And while we add it, I just wanted to add, I think, one of the biggest reasons why, like keto or intermittent fasting. Because, as you mentioned, I'm not really ever hungry. Or like normal hunger. How my colleagues and so given I work with different time zones and my schedule is driven by different meetings, I don't want to be like, oh, I'm starving, and I can't focus now, and I have brain fog because I need to have my lunch at noon. I never get to that phase. So I just like the more protein-based diet helps me with clarity. And not being food dependent on sugar, there is some sort of freedom. If I don't eat for another two, or 3 hours, I'll be okay, fine, not a big deal.

Rikke:  Yeah, exactly. My friends that came over to try out my cold lunch, they're both chiropractors, they're some of my best friends. And he was expressing how he got into intermittent fasting. He was always the hangry guy. No, I just have a black coffee in the morning, and then, um, I'm cool. I eat my lunch, and I eat a little dinner if I want to, but then no. And just learning to get that control and not feel dependent on basically a drug, which is what sugar is. It's the insulin-dependent fluctuations that are unhealthy for us.

Klara:  I agree. We can talk about that forever. We can stay here for now for 3 hours.

Rikke:  I'm not an expert. I just know what I've experimented with myself.

Klara: Same here. Right? And you probably listen to even more podcasts than I have. So we have done enough of our own experiments and reading and listening to people who are experts and played with it to adjust it to what we need for our lifestyle. And we pivot based on what we want to achieve as a goal. Right. As you mentioned, if you have a goal of gaining ten pounds of muscle, then you need to eat more, just a stick a day, but it's not going to get you there. So know your diet and align it with what your goals are. And if it's not working. You need to experiment. And iterate I also do work eight.

Rikke:  To 10 hours a day, so I got to be a little clear at my head for my patients. Right.

Klara: So you have kind of the full day of people typically packed back to back, and you got to do physical exertion because that takes quite a bit of effort to reposition and maneuver. It's hard.

Rikke:  Manual labor.

Klara:  Yes.

Rikke:  I'm not a pencil pusher.

Klara: Yeah. And for sure, powerlifting and weightlifting, and strength can come in handy, especially with larger people. Right. Not to be sexist, but I'm, um, above average female, I would say, when it comes to size and overall mass, even just like a bone mass. And I always had a hard time finding a female chiropractor that could adjust me well, just because men, on average, still have more power. Right. And so you are the only one who comes in, and you just move me. And so I think even that power and the strength that you have and you work out personally definitely helps you in your chiropractic care to be, um, more effective.

Rikke: Yeah. Uh, as a female, I have to tell you, we are smaller. We have smaller bones, and less muscle mass, generally. And we break down as chiropractors. We break down faster. Pts, nurses, et cetera. Right. We break down because we are smaller.

Klara:  One thing, actually, now that you reminded me, I wanted to go back and dive in a little bit more is weightlifting as we get older, especially women, because we tend to lose muscle mass faster than men at a certain age. And so it becomes more and more important. So I actually became way more focused on even creating a time of the year where I more focused on the raw strings, which is typically I align it to my tennis calendar, like, in the fall, like September, October, before the winter. That's where most of our raw work was done. So I kind of align it as more of raw strength and building out more of that power that carries me throughout the year because I don't lift perhaps as heavy throughout the rest of the year. But what is your suggestion and maybe protocol that you do now with weightlifting, and how much has it evolved or changed?

Rikke: When I do weightlifting, I also go back to my old routines. I used to spend a lot of time on a bicycle and running and swimming, but I always kept at least one or two days a week where I would weight lift because it's easy for me. It's easy. You don't have to think much about anything. Move some things around. Right. Move some things around. And women should absolutely do that. After menopause, we lose our main anabolic hormone. We need to actually go in and stimulate that and, uh, maintain up the metabolism by, and I say, go get a DEXA scan. Go get a scan to see where's your muscle mass at. Try to improve it a little bit every decade and maintain at least your muscle mass. Or if you're not happy with your metabolism, well, it's up to you. Just boost it. Build some muscle. You can do that at any age. I've been in practice for 30 years. I see some of my people that have been with me since they were my age, younger than me now. Right. They're in their people that keep moving. They're amazing. Right. They keep lifting or doing some kind of resistance training. They keep doing their sports. I have a tennis player that is going to be participating in the Senior Olympics or Senior what a Senior Olympics this year, right. Amazing at 80 something. Right. So it's really cool. It can be done, but everything changes as we get older, especially for women but also men. We all need to maintain that muscle mass. Don't get soft. Yeah, it's not pretty.

Klara: I love it. And definitely, I've actually been cutting down on driving in my heart rate zone every day. Like, I don't do every day, the zone five workouts, going easy on myself. I'm tired. I may do, like, zone two AirDine or a, uh, Rover, and then add a little bit more of even actually adding powerlifting or weightlifting. That's kind of typically a lower heart rate zone. So it can be good on the off days when you're torn out from vigorous activities. You mentioned you go to your go-to routine. What's your go-to routine for weightlifting?

Rikke:  What do you typically do being work? B sip. Worst school at two sip.

Klara:  What is it?

Rikke:  Is it two splits in the gym? Right? That's what we did back then. And it's always what I go back to because it's so easy. But it's, um, chest, shoulders, and bicep. Legs, back, and triceps, and then ABS and calves interspersed all the time. Right. But it's always easy to go back to that. But when I, uh, then split it out differently, I go do back and legs together, and then I do chest and shoulders and then some arms here and there, and then one to two times a week if I go to the gym. If you just get there, you're going to want to do something. Right. So even on a day when you don't want to just go over there.

Klara:  Anything we didn't talk about that we should touch base on. Any recovery protocols you recommend that perhaps you have tested work really well, other than, obviously, um, the cold plunging or that you recommend to athletes that you see that come to your office. Don't get old.

Rikke:  Don't get old. Something I often talk to people about. You come to me. And I'm not cheap. I am selective, and I put a lot of effort into every treatment. So if you want to save yourself the money, why don't you start with looking at your sleep, your hydration level, the quality of your food intake, your movement patterns, right? Means exercise, and then your social connections, those five things. If you just dial that in a little bit. Sleep can cure so many things. And a little sunlight. You start with that before you start spending a lot of money on massages and PT and chiropractic and all that. Have a little routine. And dial in the most important things. Sleep, diet, movement, hydration. And if you like people, you can have some social connections, too.

Klara:  I like it. How do you go about what proper hydration should be? Do you have a simplified equation? Because you can go crazy if you start studying it.  

Rikke:   I would try that. What's my sweat rate? Right? So you go out on a bike ride for 2 hours. You pee. First, you measure your urine. Um, you measure everything. You go in and out. You see your sweat rate because everyone's different. But then comes other factors. That how salty your sweat is, how much you actually sodium you're eliminating. But you can dial it to a certain degree. You can heat train so that you are eliminating less sodium and less water with that. And there's so much to that, right? But you got to hydrate. And I can tell you the first time I really saw what dehydration looks like. You were there because we were doing Half Dome. I came back the next day. I went straight into, uh, a phlebotomy lab, and I usually have big fat veins, and I spill blood like I'm the easiest person to draw blood on. And I had a headache for two days, right? So I am clearly dehydrated, right? And the blood comes out, and it's literally black. I actually didn't realize it until I saw my blood sick coming out. That's dehydration, and it's for real, right? That is me being at altitude. And I had it all dialed in. That hike we did for the whole day there. I dialed it in just with my food and everything. Like I would, uh, a half-ironman triathlon, right? Okay, I know what I need. My weight, the temperature. I could dial in pretty much what my food was going to be and how much water had my little filter, I could get some more water. So it all worked out, but it still had dehydration, right? That's what it looked like. It was thick, very dark blood. And that is unhealthy. And I realized, like, if you are going a whole day and drinking caffeinated drinks all day, and you're not getting at least two of these things right here, you are absolutely taxing your internal organs, your liver, kidney, and your filtration systems in your body. And that's just not good. So don't do it. You can also overhydrate, but not a lot of people do. I mean, you're going to pee a lot if you overhydrate. And then you can deplete yourself in different ways, but that is very hard to do. The kidneys have very amazing hormones to regulate that too.

Klara:  So don't over a thing. Keep it simple. On average, of the two liters, i, uh, still go in liters.

Rikke: Yeah, exactly. I get up in the morning, I drink a glass of water. 6oz. That's really what I do when I get up. And then I get in my cold plunge, I drink some more, then it's coffee, and then I try to get these down. And when people go to their eye doctors and talk about how their eyes are burning all the time and drink 16oz of water and see if that clears up a little bit. But it's amazing what you can do. Or if the sluggishness, uh, it may not be sugar, it may that you're simply dehydrated in the mid-afternoon, right, with your circadian rhythm. So it costs you nothing to drink a little bit more water and then work on your sleep habits.

Klara:  Do you have any sleep tips?

Rikke: No. I suck at it. I'm trying really hard, but I am not very good at it. But I get at least seven to 8 hours, and it sometimes ruins my morning workout. If I can't get my ass to bed at night. I don't watch a lot of television. But you got to get that Facebook and Instagram turned off that phone, put it down, and just let your mind calm down. Right. You got to do that and then slow it all down. But no, I'm not an expert on that. Uh, still working on it.

Klara: Anything else before we close off that we should touch on? Anything you would want to encourage people from your expertise, seeing people who are suffering from different conditions or trying to improve their performance and continue to be active. Anything else you would recommend them to do? Either more of or less of?

Rikke:  I've been around this area for so long. I know a lot of the doctors that are around here, and I've had a lot of surgeries myself. Right. I have metal in my back and some replaced joints. Right. Seen a lot of doctors, not just as a clinician but also as a patient; whatever you end up doing, get a second opinion or maybe even a third. Educate yourself. Doctors are just humans. They get sick and tired, and they have bad days, too. Get second and third opinions, and then if you don't click with a doctor, don't go back or chiropractor or whoever, right? You got to find people that will see the big picture. Another thing that really has come into the light here is that don't give up. If you have something that I mean, I see people with some exotic problems. I have no clue what it is. And everybody else gave up on them. I'm like, let's keep looking. We're going to send you to another expert. You don't know when you see a doctor that studies tidbits of things every day, that have seen exactly what you have before, that knows exactly what to do about it, because we can't know everything, right? I mean, I study things every day. I go through case studies that come to my inbox every day, and I try to figure out what it is, even stuff that's not inside of my profession because you never know when I could give some advice to a patient or a family member. Right? But don't give up on doctors. They may be an expert in the field, but there may be something they haven't seen before. So keep asking and stay educated. All doctors hate patients that come in with a printout from dr. Google. But I also like informed patients that have questions. So, uh, don't give up. If you have something weird, don't give up. And then when you get to my age where things start wearing out, don't wait too long before you go and have a joint replaced. I mean, you try everything, but when it's bone on bone, we don't know what to do about that other than replacing the joint. And it becomes a quality of life. You can do a lot of things with, uh, artificial joints if you stay strong and lift weights.

Klara:  Love it. Thank you. And so, last but not least, where can people find you if this conversation was interesting and they want to visit you, obviously, or they want to continue to follow you, what's the best way to stay connected?

Rikke:  You can go to my website, which is sometimes updated. That it's. My first name rikke.us. And, um, do I have a big online presence? Not really, because I don't advertise. I would love to have a blog such as yours, but I don't have time. If you want to have a conversation, or have a question, text me or send me an email. I will see that and just say put in the subject line something that will catch my attention.

Klara: Well, thank you so much for spending this amazing Thursday evening with me and talking about so many fun topics. I certainly enjoyed it, and hopefully, the listeners will find it enjoyable and informative too.

Rikke: All right. Thanks, Clara.

Klara:  Thank you. And I'm coming over to your cold plunge.