In this episode, I interview Susan Frikken, DPT. We discuss falling, fall prevention, how to stay healthy long-term, and the importance of a holistic approach to treating musculoskeletal conditions. We also discuss the Madison Area Wellness Collective, and how you can use it to find great people who can really help.

 

Here are some of the resources mentioned in this episode:

Susan’s physical therapy and massage therapy practice

Stepping On classes

Ballroom Basics for Balance

Brain plasticity

Smoking, drinking, and low back pain

Fear as a predictor of fall

Influence of therapist-patient relationship on treatment outcome

Walking is not sufficient exercise for optimal health and longevity

Transcript

Scott Robison Welcome to episode four of the Integration Bodywork Podcast. My name is Scott Robison. I’m a licensed massage therapist in Madison, Wisconsin.
Scott Robison Did you know that falling is the number one cause of injury related death in Wisconsin, accounting for significantly more deaths every year than motor vehicle collisions? Did you also know that 86% of those fall related deaths are in people age 65 and older?
Scott Robison Those of you who understand statistics know that’s an arbitrary endpoint. The real distribution probably is more heavily weighted toward the upper end of the age range but the point stands. As we get older we are more likely to fall and falling is dangerous.
Scott Robison That’s why I’m so excited to bring to you my interview today with Susan Frikken. Susan is a physical therapist, licensed massage therapist, ballroom dancer, entrepreneur, and connector of people and ideas.
Scott Robison In our interview today we talk about why it is that older adults fall. What you can do about it if you are yourself an older adult. What you can do to prevent being at risk if you are not an older adult yet and more.
Scott Robison We’ll also talk a little bit about Susan’s other entrepreneurial venture here in Madison, the Madison Area Wellness Collective, which is a group of like-minded, independent, health and wellness practitioners, which is a good group to seek out if you are a practitioner yourself looking for colleagues, or a layperson looking for help.
Scott Robison Without further ado I give you my interview with Susan Frikken.
Scott Robison Susan, welcome to the show.
Susan Frikken Hi.
Scott Robison I’m really excited to have you on today. You’ve been in the realm of physical medicine for a long time. I wanted to first give you a chance to tell us your story. How did you get from the DC area to Madison?
Susan Frikken Actually, it started in Metro Detroit where I’m speaking to you from today, where I was born and raised. I ended up going to college, undergrad, and not having a real specific aim in my life. What I ended up-
Scott Robison You too, huh?
Susan Frikken Yes. It took me until my 40s to really find my “Aha! This is what I’m supposed to be doing.”
Susan Frikken I ended up in DC and went to massage school there, which was wonderful. It was clear that this was something I would be loving to do and actually feel like I could be good at.
Susan Frikken I went to massage school at the Potomac Massage Training Institute in DC and worked part-time as a massage therapist as well as did all kinds of other jobs. I’ve done archeology. I’ve taught environmental education. I’ve taught ballroom dance. You name it. Worked as a veterinarian. Worked in a nonprofit. Worked with volunteers.
Susan Frikken What ended up happening and why I mention all of those things is because at some point I realized I wanted to do more with my massage degree, my massage certification, than I was allowed to do by law. I was trying to figure out what should I-
Scott Robison I know the feeling.
Susan Frikken Right. Should I be a personal trainer? I wanted to be able to offer people more. Again, more by training and more by scope of practice. I researched. I was working in a healthcare nonprofit with the Whitman-Walker Clinic, which is Whitman-Walker Health now in the DC area.
Susan Frikken I was really very interested in working with people preventively. That gave me a lot of passion and respect for people coming from all walks of life. Just seeing how people struggled and the things that they struggled with multi-dimensionally.
Susan Frikken Looking for jobs, because our office was closing, I saw there were tons of PT openings. I thought “What is physical therapy, anyway?”
Susan Frikken When I looked into I thought “This might be the way to go.”
Scott Robison Can you place this in time? Sorry. Really quick. Can you place this in time here? Where are we?
Susan Frikken I’m in the DC Metro area. Northern Virginia. This is the mid 90s. I had been out of massage school for about five or six years. I had been working with volunteer massage therapists who provided services to people with HIV, gay and lesbian, transsexual people, in this nonprofit. Doing a little bit of my own work on the side.
Susan Frikken I took a class. I thought “Can I go back to school? Is this going to work?”
Susan Frikken Slowly but surely I decided that I would like to pursue that path.
Susan Frikken At the same time my partner and I were deciding to leave the metro area of DC and ended up back in Wisconsin where I had gone to undergrad, which is where we live now in Madison. I figured I could do massage there and I could go to school there.
Susan Frikken That’s how I ended up in Madison and was pursuing this career, trying to get into PT school. I took the prerequisite classes there in the area while I was starting a new business in Madison doing massage.
Susan Frikken By the time I ended up getting into PT school … It took me two tries. They rejected me the first time.
Susan Frikken I had acquired a whole bunch of other great experiences that I think made me a better person in school and I already had a good business going. While I was in PT school I had all these wonderful people who allowed me to practice my new skills with them.
Susan Frikken I graduated from UW Madison in 2013. I am now both a massage therapist and a physical therapist. I call myself a physical therapist when I need to keep it short. I can tuck everything under that umbrella.
Scott Robison Do you keep both licenses active or just the PT license?
Susan Frikken I do. I’ve had the discussion recently with somebody else who is going on the same path. I feel like massage therapy is really special training.
Susan Frikken Physical therapists do not get very much soft tissue training in school. They used to in the long ago years. If anybody is good at it as a physical therapist that means they’ve had a lot of post graduate education.
Susan Frikken There are lots of people who are good at it but it’s not assumed that a physical therapist is good at soft tissue work. I think it’s important to spell that out to people. I think to give my first field the kudos and the respect, it means I value that degree.
Scott Robison I appreciate that. I interviewed Adam Lindsey a few weeks ago. He introduced us. He is a manual therapist primarily. As a small business owner he gets the luxury, as you do, to spend 30 minutes or an hour with a patient instead of 15, 20 minutes.
Scott Robison You’re trying to do intake and assessment and provide some sort of home exercise plan, which is where the money really is for most folks. There’s just no room.
Susan Frikken It’s true. But I really appreciate the ability.As a massage therapist in private practice, I thought “If I can go to PT school and then expand what I’m doing that would be great.”
Susan Frikken I was really able to. I thought maybe I’d have to “put in my time” in the mainstream medical system. I didn’t end up having to do that. I don’t feel alone either. I feel like I’ve been able to create a really good network of colleagues. Like Adam, for example, whom I aspire to be like one day. He’s such a great therapist.
Scott Robison Me too. Since you’ve been in this field for so long, what would you say are the biggest … Improvements is so judgemental. Let’s call it the biggest changes in how massage therapy and physical therapy approaches patient care.
Susan Frikken Massage therapy, I think, is finally getting a little organized. There are so many different modalities. Bodywork and massage. You could say that to somebody. “What does that mean?”
Susan Frikken I think we’re getting better as a profession at explaining what we do when we’re with someone and the different kinds of work.
Susan Frikken I do think massage is being used more in … It’s returning to the medical setting a lot more as well as being in wonderful places like spa settings. All the different places where it’s valuable. That seems to be one way I’ve noticed. It’s a lot more organized and it’s a lot more clear. The public seems to be a little clearer about what we do.
Susan Frikken Physical therapy, it’s moving to the doctoral level across the board. That means it’s also becoming more medical mainstream, which may or may not be beneficial.
Susan Frikken I do think it’s really helpful that the physical therapy profession has moved from an illness model to a wellness model and from a “I’m going to fix what’s wrong with you model” to a patient centered care model, meaning it’s always got to be the patients at the center, and a more holistic approach to care.
Susan Frikken We are really good at screening for things that maybe we can help people stay well sooner.
Scott Robison I saw that you have explained pain listed as a resource on your website. I’m banging the drum of pain science as hard as I can in my little corner of the world. Having that perspective certainly helps you help people manage the things that are not just “My elbow hurts when I bend it.”
Scott Robison It’s also “But you’re also smoking. You don’t sleep. You work 60 hours a week. Maybe your elbow might feel better if you didn’t do those things.”
Susan Frikken Right. Bringing that up, it makes a lot of sense what you said about both fields: both massage and physical therapy moving more toward evidence based practice, which people can get kind of stuck on and ignore everything else sometimes, which I don’t think is a great thing.
Susan Frikken I think having some structure for “There’s some evidence out there that working on your stress can help your back pain,” for example, or the contributions that the mind makes. Like you said, the pain science to your pain.
Susan Frikken We’re going to give you back some power that you’ve given us too long in the medical field over your own wellness. Hopefully, cut costs and make your life a lot more enjoyable.
Scott Robison I had a really interesting article on that note. I put it in my weekly newsletter a week or two ago. It was an interview with a physician who is doing clinical research with open label placebos. They’ve done a couple of trials. One with irritable bowel syndrome and one with lower back page, which are notoriously difficult to treat from a traditional medical standpoint.
Scott Robison There are plenty of symptoms but there are no signs. There’s no markers that they can test for. Basically, it’s an intervention where you have all the pageantry of going to the doctor. Then they say “This probably won’t work but other people have reported success with it. Maybe you should try it.”
Scott Robison Sure enough, it works.
Susan Frikken That’s wonderful.
Scott Robison I want to switch gears here a little bit. You’ve alluded to your diverse interests and entrepreneurial nature. I want to talk about balance and fall prevention. You’ve created this Ballroom Basics for Balance program. You’re an instructor for Stepping On. Why are you so interested in balance and fall prevention?
Susan Frikken That’s a really good question. I’ve often asked myself that. Prevention just makes a lot of sense to me. I love working with all kinds of people. Older adults are one population that, for some reason, I really enjoy working with.
Susan Frikken Again, I’m not really sure of all the reasons why. Preventing falls in all people, especially in older adults, is so valuable. In terms of quality of life. In terms of saving us money in the healthcare system. It’s just another prevention.
Susan Frikken I’m really interested in prevention and keeping people well. Once people don’t feel well or have an injury or an issue then it’s really hard to get back to feeling yourself again. I think it does have a lot to do with this makes too much logical sense.
Scott Robison I was looking at … I think it’s the Wisconsin Institute for Aging report on falls. Falls kill more people per year than motor vehicle crashes.
Susan Frikken Isn’t that incredible?
Scott Robison Yeah. That’s amazing. It was 80 something percent of those people are 65 and older. Why do old people fall so much? I’m going to take a pause here and say I’m probably going to offend some people by the way I say “old people” or “elderly folks.” Maybe you can help me out, Susan. Is there a better way to say that?
Susan Frikken People prefer different things. Older adults, I usually say. Depending on the group I’m with, I can use all kinds of things. Some people enjoy humor. Some people are really particular about not feeling like old person. So I usually say older adult.
Scott Robison Got it. Thank you. So why do older adults seem to fall so much?
Susan Frikken There are a couple reasons. It’s often multi-factorial. One thing is weakness. Especially in the lower half of our body: our hips and our legs. Our ankles. Our feet.
Susan Frikken Stiffness in all of those joints too can cause trouble for people. If your body isn’t as pliable and can bounce back as easily, if you hit a bump while you’re walking … But strength is probably one of the number one issues. We lose strength, one, because we stop using our bodies in the way that when we’re born we do.
Susan Frikken If you’re lucky enough to be born healthy … Watch a child move. It’s the best lesson in how adults should move. We get out of the habit because of the jobs we have, because of the life we live, because of sitting in chairs and driving-
Scott Robison Right. The built environment.
Susan Frikken We start depending on our environment and stop depending on ourselves. Two, our spine can become compressed over time. The nerves that come out of our lower spine, that feed our legs, often can get squeezed off maybe with some issues.
Susan Frikken Degenerative disc disease. Maybe stenosis. Things that affect our nerves that then make it harder for our leg muscles to be normally strong.
Scott Robison That’s a really interesting point. I know that a lot of the research we’ve seen recently on systemic people is lose of disc height and arthritic changes to the joints and some of those things are normal parts of aging. I haven’t looked for it admittedly. Have there been any studies correlating those particular radiographic signs with decreased strength?
Susan Frikken There are studies out there. I couldn’t quote you any right now. I’d be happy to pull them out and followup if you want to.
Scott Robison That would be lovely.
Susan Frikken There are some, yeah. Anything that affects those obturator, femoral nerves feeding … Especially our glutes and our quadriceps.
Susan Frikken There’s strengths and there’s we get out of practice. We stop moving in all the ways and our body stops remember how to react and respond to things. Then our environment can trip us up.
Susan Frikken Vision is another huge one. As we age, our vision declines. It’s part of what happens. If we don’t keep up with it and manage it well then that can really put people at high risk falls.
Susan Frikken Those are some of the big ones. There are other issues too but those are sort of the mains ones.
Scott Robison You sort of touched on this already: this idea of loss of physical capacity insidiously. You don’t notice it until it’s dropped below a certain level. Are there some straightforward … Easy is the wrong word, right?
Susan Frikken Mm-hmm (affirmative)
Scott Robison Straightforward ways to help people avoid getting to that level in the first place.
Susan Frikken Remind me, I’ll touch on fear later too and some ways that people can help remedy. How not to get there in the first place: I have a couple what I call rules. I’ve distilled my private practice into just four things if people walk away with nothing else.
Susan Frikken One, don’t plop. Two, don’t lean. Three, move quietly and mindfully. Four, stand tall. Those things are simple, I think. And direct. By not plopping, stop falling into a chair. Use your muscles. Then you won’t get weaker. You will keep your good muscles that allow you to get up and down from a chair, for example.
Susan Frikken Don’t lean is another one. Quit leaning on the railing. Quit leaning on your own self. Use your muscles to stand up tall. I’m a big fan of the anatomy trains, for anybody who is familiar with it, and the idea of tensegrity, meaning use your bones to support yourself but also use all those great bouncy, elastic muscles that you have, that you always have a way to get in touch with to help hold you ups.
Susan Frikken Three, moving quietly. If you could move purposefully throughout your world, walking heel to toes. For example, very quietly up the stairs. Very quietly. Most of your postural muscles will kick in. In other words, the things that we’re trying to get your body to do again are going to natural want to do.
Susan Frikken Then just standing tall. Feeling tall. If you have an injury or something, make sure that you rehabilitate it well so that you don’t end up with weakness or other deficits that are going to put you at a higher risk for falls.
Susan Frikken The other thing too: medication management is a big thing putting people at high risk for falls. Making sure you’re taking as few medications as possible to keep yourself healthy and that you get them reviewed at least once a year.
Scott Robison How does medication increase your fall risk?
Susan Frikken Four or more prescribed medications puts people at higher risk for falls. Usually it’s because of the kinds of medications people take that have side effects like dizziness or low blood pressure. Lightheadedness. Making people foggy if it’s an antidepressant or a blood pressure medication.
Susan Frikken Also, they interact with one another and can amplify each other’s side effects. Those are a lot of the reason why. They mess with our normal equilibrium.
Susan Frikken Environmental safety is another way people can reduce the risk of falls. Make sure trip hazards are taken care of. Loose rugs. Making sure you have a handrail when you need one. That kind of thing.
Scott Robison You said you wanted to touch on fear.
Susan Frikken Yeah. Fear is a big thing. There’s a great study. I can give you the reference if you like. I don’t have it off the top of my head. There is a great study that shows that the risk of fall, if you have had a fall or a near fall, you are at higher risk for another fall more from fear of falling than actual, physical deficits.
Susan Frikken Let’s say you’ve had a fall and you have weak muscles. You are more at risk if you are afraid. If you work on your fear of falling and your awareness, “I know what I need to do,” you lower your risk more significantly, even if you work on that deficit.
Susan Frikken To me, that’s stunning. That means everybody can do something. Even if you’re limited in how much you have stuff going on with your body, and you’re limited in how much you can get stronger, you can still reduce your risk quite a bit. That’s exciting. That means confidence and awareness are huge.
Scott Robison Awesome. Speaking of competence, I would imagine that’s a pretty big feature of both the Stepping and Ballroom Basics for Balance.
Scott Robison That is really hard to say, by the way. I keep wanting to use a different consonant sound to say one of the those.
Susan Frikken We call it BB4B, which I don’t know is even easier to say.
Scott Robison That’s probably easier as long as you know what it stands for. One of those is your program. One of them you teach for. Can you give us a quick run down on what those two programs are like?
Susan Frikken Yes. I first started working with Stepping On after I graduated from PT school. It’s an evidence based program that is seven weeks. You meet once a week for two hours then again three months later to check in.
Susan Frikken It’s a wonderful program. Happens all over the world. Was started in Australia by a woman named Lindy Clemson who did research to see what would help people reduce falls. The key elements are it is a social support group type setting. People help one another. We act as knowledgeable facilitators.
Susan Frikken We have a curriculum. We collect date from every class that’s held. It holds true over time that when you address things in this multi-factorial way … We do exercises for strength and balance. We address medication management. Vision. Home safety. All those things we talked about.
Susan Frikken People become more aware and more confident like I was talking about. It’s wonderful and it’s really exciting because people make different choices. They change their bodies. They change their perception of what they can do. It’s a wonderful program. It’s a support group model, like I said. It’s a really neat program.
Susan Frikken You can look it up and it happens all over the place. If people want to start a class, they can ask “How do I get a class going in my community?”
Susan Frikken The Ballroom Basics for Balance, we started teaching that in the spring of 2014. That was born of an idea I had. I was working with a gentleman on balance at a nursing facility. We were doing sideways walking. Backward walking. Doing some of these leg lifts that you do for Stepping On. Typical physical therapy things that actual work to help people get better.
Susan Frikken It’s so boring. I thought “If we could put on some music we could dance instead.”
Susan Frikken I could not get the idea out of my head. I kept thinking “I don’t need to do this right now.”
Susan Frikken But it kept coming back. I recruited some friends and colleagues. We started it. Since then, it’s grown to become really fun. We’ve got more classes. Starting a new one in La Crosse, which is exciting this year.
Susan Frikken We recruit students to help us so they get to learn what their sitting in class learning about. Balance and fall prevention. They get to come and dance with older adults. It’s really a hit: this intergenerational way of getting the physical component of balance and fall prevention down. Dance is one of those activities that works all of the elements into it.
Scott Robison Plus it has the music piece, which is a different brain stimulus than just speech and just movement.
Susan Frikken What’s really cool is there’s another study, which is on our website for Ballroom Basics. We’ve got a little research area where we put up relevant research articles. It’s really fun.
Susan Frikken There’s a study out of Italy about having a really great balance and exercise fitness program compared to dance. They both were really great in improving people’s balance. The thing that dance did better was it made the hippocampus grow. Which is huge! Which is kind of cool.
Susan Frikken Dance has it all built right in. Like you say, music works with memory. We’re hoping to go down that path with some students. We recruit students to do little projects with us too.
Susan Frikken They’ve made us a home practice video, which is up on our website, that anybody can do. Even if they can’t come and take the class, they have done all kinds of things. This year we’re hoping to get people to help us look into what role music has to play and how we can use it the best for helping people move better.
Scott Robison Besides the effectiveness, I think it’s such a great idea because, as you say, corrective exercise, except for weird people like me and maybe you too, is really boring. Nobody likes to do it. Every PT or other therapist who sends people home with a home exercise plan bitterly complains about lack of compliance, right?
Susan Frikken Yes.
Scott Robison But fun, it’s so different than regular, general exercise programs. People ask me “What should I do to workout?”
Scott Robison Go do something fun with other people.
Susan Frikken Yes. And it’s so important. One other thing that’s linked to both of these things, in Dane County, Wisconsin, where I live, there’s a nonprofit that manages our Stepping On classes. It’s a little different how they happen everywhere.
Susan Frikken This group is called Safe Communities of Madison and Dane County. There are Safe Communities all over the country. What they do is they address issues of morbidity and mortality in the communities where they are. One of the highest is always falls.
Susan Frikken I’m on a community for Safe Communities. Their website is safercommunity.net. You can see all the things that they’re doing.
Scott Robison We’ll put all that stuff in the show notes.
Susan Frikken Great. I’m on a committee there. What we’re doing is, after the Stepping On classes, people do well for a while and then they fall off on their exercises. They’ve gained confidence and awareness. They’ve probably made some lasting changes but it’s always the exercises that fall off.
Susan Frikken What we’re trying to do is figure out how can we get people more excited about exercising and moving around so they don’t fall down so they are happier and their quality of life is better?
Susan Frikken We’ve come up with this wonderful tool that is a handout for people that they can take and hold up to an activity at their community center and say “Does this activity qualify as a balance enhancing activity?”
Susan Frikken For example, it has four criteria based on the things that we know work. I won’t go into too much detail but people can use that really simple tool to then say “Tai chi, yeah. That fits the bill” or “How about the senior exercise class? It might. I’m not sure.”
Susan Frikken We also have a tool for instructors of classes so they can incorporate all the things that do matter. They may be almost there. They may have strengths. They may have one or two of the other bits but they may not focus enough on something else.
Susan Frikken We’re trying to educate the public, people taking classes and people giving classes, about how to find fun things, like playing ping pong for example, fits really well. Dancing fits really well. Tai chi. Some yoga. Some other activities.
Susan Frikken These are all really neat things. People can go “Great. I’m going to go do this instead of doing my boring PT exercises.”
Susan Frikken As long as they’re doing something, that’s the important thing.
Susan Frikken Instructors can then enhance their programs. We’ve got associate videos. All of this is going to be on the Safe Communities website for anybody to have. We have a YouTube channel with video examples then we’ll have the documents there for people to download. That should be up at the end of August 2018.
Scott Robison Terrific. I’ll link to all these websites we’ve mentioned. All these resources will be in the show notes for people to find.
Susan Frikken Great.
Scott Robison Let’s see. Briefly, if somebody wanted to find a Ballroom Basics for Balance class or Stepping On, is that the easiest way? To go to their websites?
Susan Frikken The easiest way for the ballroom is to go to that website, which is ballroombasicsforbalance.org. For Stepping On classes in Dane County, you could go to safercommunity.net.
Susan Frikken Better yet, for classes all over the country, Wisconsin Healthy Aging, which wihealthyaging.org. That has the clearinghouse of classes at any given time across the country. That’s where people can say “I would like one in Akron. We don’t have one here. Can you help me figure out how to get one?”
Scott Robison Got it. That’s great. Awesome. We’re going to take a quick break. It seems like a good spot for it. When we come back we’ll talk about another one of these great community organizations you’re involved with: the Madison Area Wellness Collective.
Susan Frikken Great.
Scott Robison This episode is brought to you by Integration Bodywork. Is your body holding you back? Your back pain makes you afraid of picking up your kids? Your sciatic pain is preventing you from training for A priority race? Maybe your shoulder mobility is preventing you from snatching or doing Kipping pull-ups?
Scott Robison At Integration Bodywork, I help people overcome these obstacles with posture and movement assessment to find the hidden limitations and the most effective manual therapy techniques backed by research.
Scott Robison If you’re ready to move better, feel better, and live better, go to scheduling.integrationbodywork.net and schedule your first appointment.
Scott Robison And we’re back. Susan, you’re one of the founders of the Madison Area Wellness Collective. Tell us what that is. We were talking off air just now that you had an itch that you needed to scratch. Can you tell us about that?
Susan Frikken When I began my private physical therapy practice, slowly came to the awareness from networking that there were quite a few people working private practice and doing really innovative things in physical therapy. At least in the region where I was.
Susan Frikken Since then, I’ve realized that they’re all over the place. Not everybody works in mainstream medical systems. That was exciting. I thought “We should be connected.”
Susan Frikken I call it one of my nervous ticks or one of my superpowers: connecting people and things together. I can’t stand an unconnected obvious connection. I thought “Why don’t we get together and we can share ideas and resources and business stuff?”
Susan Frikken A small group of us got together. That was the fall of 2013, I think. We all realized this has to be broader than just us. We invited some colleagues who were doing other things like chiropractic and occupational therapy. Other things like that.
Susan Frikken I think a few of the common threads are, one, we all wanted to give back to our communities in some way. Not just to have a business. Two, we were all doing something slightly outside of the box. It might not be extreme or extraordinary. Something that was harder to do because of time in a mainstream setting or just because of internal protocols. Maybe it was really outside the box.
Susan Frikken That’s kind of how that started. We’ve been gathering regularly ever since and it’s grown quite a bit.
Scott Robison Looking at member list, it is quite diverse. You’ve got everything from, as you say, traditional physical therapy to Pilates. There’s yoga. There’s all kinds of interesting things. What do you mean when you say outside the box?
Susan Frikken For example, maybe people doing energy medicine or more integrative approaches. Things like visceral manipulation that a lot of therapists can do other than massage or occupational or physical, which works. A lot of us haven’t been trained in mainstream anything to consider the organs.
Susan Frikken Maybe that’s a gynecologist. Maybe that’s a GI doctor. They’re part of the rest of us and they’re connected to the rest of us. When we have a black box in the middle, for example, that’s one modality that might be considered sort of outside the box. It’s physical. It’s physiological. It’s just something that’s not usual. Those are some examples.
Susan Frikken Nutritional approaches that aren’t typical dietetics based on USGA guidelines or something. People who are looking at allergies and genetics related to nutrition. That’s a little outside the box too. It’s interesting.
Scott Robison Who isn’t in that collective? There’s an application process. What does that look like?
Susan Frikken I like that. I like the “Who is not in there?”
Susan Frikken The one thing in all of my realms is that there aren’t enough people from the non-expected population. We’ve got a lot of people from educated, socioeconomically advantaged groups. Otherwise, we’re missing a lot of representation from culture and socioeconomically disadvantaged people in our communities.
Susan Frikken A lot of people of color are not in the group. That’s one things that I know. We’re out there doing the work but we need the connection.
Susan Frikken We don’t have a lot of MDs. We have had a couple MDs in the past. A lot of it is they’re busy. We’re all really busy. It’s harder for other people to stay in touch based on-
Scott Robison Do you feel like … Sorry.
Susan Frikken No. Go ahead.
Scott Robison I was thinking about the privileged status that a lot of people, as you say, in your group have. Last time I looked at the American Massage Therapy Association’s state of the profession report, overwhelmingly massage therapists around the country are white.
Scott Robison Do you feel like that disparity is reflective more of the group? More of Madison and Dane County? More of the professions who are represented there?
Susan Frikken I think it’s all of the above. I really do. I do pay attention to those things. I know that, for example, UW Madison has … A couple students started a really wonderful group called ADEPT, which is Advancing Diversity and Excellence in Physical Therapy. Their mission is to try to get more people in the profession who aren’t white, middle class. It’s really great.
Susan Frikken They actually provided a grant to the Wellness Collective this year to have our first wellness fair. Our goal was to reach out to people. Especially who might not know about wellness stuff. Give people experiences. We’re trying to reach into communities and figure out people who don’t normally have access. Whatever that means.
Susan Frikken It’s neat. We do have diversity within the group. Not everybody is well off and able to access things. Even have a great healthcare plan. We’re trying to do more of that.
Susan Frikken A lot of members of the collective do a lot of volunteering and a lot of pro bono services in their communities in various ways. It’s pretty cool. I think if anything is going to happen this group is going to help it happen where we live.
Scott Robison I’m glad to hear there’s, as you say, pro bono work going on. That’s something I have struggled with and have not solved the puzzle for yet.
Scott Robison I have three kids now. How do I create a business that supports us? In tandem with my wife, who also is working and going to graduate school. How do we balance that very real need to generate income? Daycare is expensive. With a real desire for social justice work that’s a challenging balance.
Susan Frikken Our services need to be valued. It shouldn’t be expected that providers or interpreters donate their services. I think there are multiple levels. Yes. We should give where we can. However, we should also work for justice and equality in the systems that we operate in.
Susan Frikken I think we have to ask the systems to step up and our communities to step up and fill in. Get better at providing so that we can all make a living. Help one another. Provide literacy.
Susan Frikken One of the other things I do right now is I am fortunate enough to teach now at the UW PT program in the summers. Health promotion and wellness. We were talking about the students the other day. They were saying “How is this paid for? How does wellness and prevention get paid for?”
Susan Frikken That’s the question of now. There are ways. There are innovative things and things we’re returning to in the medical systems that are starting to gain traction. Like group appointments: people getting together as a group of maybe people who have diabetes.
Susan Frikken They go to their doctor but most of the appointment is spent in a support setting with each other, helping each other learn how to eat well. Prevent adverse things from happening. I’m really hopeful that things like that are going to be the future and that we get to participate in that as well.
Scott Robison That’s terrific. Are those sorts of events … That’s not really an event, right? That’s a program through your doctor. Let me ask this a better way: what kind of events that fall under these umbrellas are available through the collective? What do you guys have on your calendar?
Susan Frikken Slowly but surely we are hoping to do more public events. That’s one thing we’ll be talking about at our upcoming meeting this Wednesday, the 11th. We have quarterly, approximately, membership meetings where anybody can come. It doesn’t have to just be people who are members.
Susan Frikken To become a member … I didn’t answer your question before. You go to the website, which is madisonwellnesscollective.org and click the join button. It’s real simple. There’s no obligation of money or time. You don’t have to show up to anything or participate in anything at all.
Susan Frikken We have quarterly get togethers where we try to see each other face to face so that we have a chance to learn from each other and learn about each other. Maybe make some plans for events. Those are things that are happening.
Susan Frikken We’ve done some social events and will continue to do those as a group as another way to bring out community closer together. We’re hoping to do a little rejuvenation starting this year by trying to figure out what other ways can we be present in our community. Can we go to health fairs and be on a panel? Those are some of the things we’ve talked about.
Susan Frikken Right now a lot of this is in the growth phase, where we reach the point of “We have enough people and enough great ideas that we can now be more part of the community.”
Susan Frikken Sorry about that.
Susan Frikken We’re hoping to maybe do another health fair this coming year. Doing some more community workshops as a group.
Susan Frikken A lot of our members, if you look on the calendar on the website, there are wonderful, wonderful offerings, some of which you pay for, some of which you don’t, that you can find there on the calendar.
Scott Robison That’s terrific. All right, Susan. I’ve taken up enough of your family’s vacation time there. If people want to get in touch with you about Ballroom Balance or physical therapy, or any of the other things you’re involved with, what’s the best way for folks to get a hold of you?
Susan Frikken Email is great. You can find it on my website, which is yaharatherapy.com. Y-A-H-A-R-A. Therapy.com. That’s the name of a local river where I live. It has my email address and my phone number. My fax number. All right there.
Scott Robison Got it. Terrific. Are you on social media anywhere?
Susan Frikken I am not. I am not. I chose not to go down that path because I didn’t think I had the energy to keep it up.
Scott Robison Understood. Terrific. Susan, thank you so much for-
Susan Frikken That’s not true. I apologize. I am on LinkedIn. There’s a link to that link. That’s technically social media, yeah.
Scott Robison That is social media. That’s true. Got it. Terrific.
Scott Robison All right, Susan. Thank you so much for taking the time out of your vacation to speak with us today. I’ll look forward to seeing you in person at one of those meetings in the future.
Susan Frikken I hope so too. Thank you so much.
Scott Robison Thanks, Susan.
Susan Frikken Bye.
Scott Robison That’s it for this episode of the Integration Bodywork Podcast. If you enjoyed it, please subscribe on Apple Podcast, formally known as iTunes. That’s how other people find the show.
Scott Robison If you’d like to find out more about us and what we’re up to, go to www.integrationbodywork.net, where you can find show notes for this and every episode, subscribe to the famous weekly newsletter, or schedule and appointment.
Scott Robison Thanks for listening. I’ll talk to you next week.

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