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56: Sports Medicine Listener Questions

Oct 13, 2020

Sports medicine physician Dr. Christopher Gee answers listener questions about back pain between the shoulder blades, whether a meniscus will heal on its own, and arm care for kids who play baseball. Plus, is back to Thunder-truth or Thunder-debunk whether eating five meals a day speeds up the metabolism for weight loss.

Episode Transcript

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Troy: I told Laura I'm just like the Ed McMahon to Johnny Carson, and she's like . . .

Scot: No, you're not.

Troy: She said, "Don't give yourself that much credit." I said, "I'm just here just for the da-da-dum."

Scot: No, you're not. I mean, you are funny, but you bring information. Most of the time you're funnier than I am.

Troy: I'm just here to . . .

Scot: Which really bugs me. We're going to talk about that some time.

"Who Cares About Men's ÈËÆÞÖгöÊÓƵ," providing information, inspiration, and motivation to better understand and engage in your health so you feel better today and in the future. My name is Scot Singpiel. I'm the manager of thescoperadio.com, and I care about men's health.

Troy: And I'm Dr. Troy Madsen. I'm an emergency physician at the ÈËÆÞÖгöÊÓƵ of Utah, and I care about men's health.

Dr. Gee: And I'm Dr. Chris Gee, and I'm a sports medicine physician at the ÈËÆÞÖгöÊÓƵ of Utah, and I care about men's health.

Scot: Dr. Gee, it's great to have you back on the show. We had Dr. Gee on last season, when Mitch rolled his ankle, to talk about what it's like to deal with a sprained ankle. So if you've ever had that happen, we've already had that conversation with Dr. Gee, so you can go back to our last season and find that out.

But today, we wanted to do kind of like a sports medicine doctor Q&A. Before I get started, though, I wanted to know, Dr. Madsen, what'd you think when I said we're going to have a sports medicine doc on? What was the first thing that went through your mind?

Troy: Sports. Thinking about sports. Well, I think that's what a lot of people think. Chris, I'm sure you hear this a lot, but I think a lot of people hear sports medicine . . . I'll see an 80-year-old in the ER who has an injury and everything, maybe X-rays show a fracture or maybe they don't, but I'll refer them to sports medicine, and it's like, "Sports medicine? I'm not playing sports." So I think maybe that's people's first impression, that your primary target here is athletes, like college or high school athletes. I think that's often what goes through people's minds. Dr. Gee: For sure, yeah. It's one of those things you end up . . . I get a lot of patients that come in and say, "Why are you seeing me?" or don't understand really what the specialty is. It's really kind of more activity medicine and being active, but I guess that is where we're at.

Scot: So activity medicine, do you deal with stuff like back pain, that sort of thing?

Dr. Gee: Yeah, we do. We'll see some pain . . . basically kind of any joint in your body, anything that's non-surgical orthopedics is kind of the way I put it.

Scot: All right. So you're on an expert on the bones and the ligaments and the muscles and how they all work? Is that what a sports medicine doc kind of really knows?

Dr. Gee: Yeah, that's basically it. And we work on all ages, so anybody kind of from a weekend warrior, professional athlete, or even just somebody trying to get that knee to not act up as they're walking around the block.

Scot: All right. Sounds good.

Troy: And we know you're a great doctor, Chris, because you got Mitch through his 5k. He had his sprained ankle, you saw him, you cared for him, he did his rehab, and he got through the 5k. He did it.

Scot: Let's go ahead and hit the questions here. So we've got three questions we're going to try to get through for Dr. Gee, our sports medicine doctor on "Who Cares About Men's ÈËÆÞÖгöÊÓƵ."

There are a lot of different ways that people could have gotten these questions to us. They could have emailed hello@thescoperadio.com, they could have gone to our Facebook page, facebook.com/whocaresmenshealth, and direct messaged us, and then we also have a listener line nowadays, where you can call and leave a message, and that phone number is 601-55SCOPE. That's 601-55SCOPE.

So here's the very first question from our listener line. Here's a listener that had a question.

Man: Hey, guys. Love the show. Hey, I have a question. I have a pain that I experience kind of in between the shoulder blades. It's been kind of off and on for the past, I don't know, I'd say maybe five years. I don't really remember injuring it. I work in an office. It's not so bad that I need to . . . I don't know. I don't know what to do about it. Thanks for letting me know.

Scot: All right. Dr. Gee, do you have any advice for that individual? Do you see a lot of back pain? Is that something that you do see? I did bring that up earlier, but I didn't quite catch what your answer was.

Dr. Gee: Yeah, we do. You tend to see a fair bit of back pain in a lot of different patients, a lot of different environments. In this case, what it gets me thinking, particularly if it's sitting in an office and having to kind of sit forward, that's a tough position on the shoulders and on the upper back. And over time, spending all that time in that position does tend to weaken the muscles around the upper back and particularly around the shoulder blades.

And so as those muscles kind of get a little weaker, they put the shoulder in a bad position, and then those muscles are trying to kind of hold it back and it can definitely cause some discomfort.

It's something I'll see pretty regularly that people will have some pain or problems with their muscles that stabilize the shoulder, and so putting them through some therapy and some exercises to kind of work on those muscles as well as just working on position, looking at your desk and making sure you're trying to sit in a good posture as much as you can, or even getting up and walking around a few times an hour can help just to kind of break up that monotony.

Scot: Hey, if I wanted to do a little bit of research for some exercises, what are the muscles that we're talking about back there?

Dr. Gee: So particularly the scapular stabilizers are the ones I'm thinking of, the rhomboid major and minor, some trapezius, and even some of the rotator cuff muscles through there. And then there are some very important muscles in the upper spine, the erector spinae muscles, that kind of help to keep us upright.

Scot: And those muscles that you mentioned, with the exception of the erector spine . . . the erector what muscles? Spinae?

Dr. Gee: Yeah, erector spinae.

Scot: The erector set muscles?

Troy: This guy, haven't you been working out your erector spinae muscles lately?

Scot: No. I've neglected it.

Troy: Isn't it part of your routine?

Scot: That was actually my question. Those other muscles you mentioned, the rhomboids and the trapezius, in our kind of day-to-day life, if we're not doing any sort of activity, those are kind of ignored muscles in general. We're not really exercising those, are we?

Dr. Gee: You look at just what we do through the course of the day, and so much of it is just right in front of us. You're holding your phone right in front and your shoulders are sloping forward, and your upper back is sloping down, and you basically put those muscles kind of into a stretch and they're never having to really engage. And so doing some exercises to increase the activity of those muscles and really bring them back into position just helps to open that up and decrease pain.

Scot: Is there such a thing as a muscle falling asleep? Like, because you don't use it enough, it kind of forgets to fire and you've got to kind of reawaken it, so to speak?

Dr. Gee: Sort of. Basically, muscles are worked by activity and exercise, and when they are used, they hypertrophy and those neural pathways get a little more prominent. And if they're not used a lot, they get weaker as well as if they are having pain, they'll get inhibited, and so they're not used as appropriately as they should be.

Troy: Now, Chris, I don't know if you know, but Scot is really into kettlebells now.

Scot: I'm not really into it. I just got started.

Troy: I'm guessing some good kettlebell swings is going to work a lot of those muscles. I don't know if you're familiar with the kettlebell swings, but . . .

Dr. Gee: Yeah, they can work some things out, but you have a high risk of injury, so maybe you'll end up seeing Troy. I don't know.

Troy: Drop it on your foot.

Scot: There can be. I've been exercising with strength training for a long time, and I'm really a stickler for form, so I'm being very careful with the kettlebells.

Dr. Gee: That's perfect.

Troy: So what about an MRI? Would you tell this person, "Hey, it's been five years. Let's get an MRI and see what's going on in your back"?

Dr. Gee: It all depends on the symptoms that they're developing. It does tend to be less common to get thoracic vertebrae problems or disk problems just because it's a more stable area. Oftentimes, we'll put people through some therapy first and see how it will do, but eventually, if it's not improving, they may need other imaging, something like an MRI, to see if there is something else causing the symptoms and the pain.

Troy: And what about surgery? Are you ever recommending surgery in these patients, like if he's just like, "Hey, this has been going on long enough. I want to get this fixed"? Or any kind of injections?

Dr. Gee: Yeah, injections are usually the next step. Let me step back. There's a bursa or a little sac that sits underneath your shoulder blade, and sometimes that can get inflamed and be a source of pain. So sometimes doing injections there or even surgically debriding it can be helpful. But a lot of those muscles get tired. They can get trigger points, they can have a lot of irritation, and so doing injections into those muscles can be helpful.

Scot: And when you say therapy, is that just short for physical therapy? Is that what you mean?

Dr. Gee: Yeah. And physical therapy involves a lot of things, anything from manual therapy where they're doing actually massage and stretch or dry needling all the way up through and including exercises to kind of strengthen areas.

Scot: I've had the exercises for a couple of issues, and I've got to say it's amazing how well they work after a couple of weeks. It really is.

Dr. Gee: For sure, yeah. I've always found that pretty interesting too. I'll get very skeptical looks from people when I tell them, "Hey, this is what you need to work out." But once you do it, you realize, "Wow, it's stabilizing that joint, increasing the control of the muscles over it. Really helps a lot."

Troy: And you mentioned massage, Chris. Is that something you're telling people, "Hey, go to a massage therapist. Try this out and that'll make a difference," or is it more of the PT, the exercises, that kind of thing?

Dr. Gee: I do like massage as far as a modality to treat some of the pain. The hard part is that a lot of insurances don't cover it, and so it's a little tough. But yeah, different kinds of massage can help, particularly if you're having muscles that are having to go into spasm to try to hold position in your back or neck or shoulders. They get really tired, and so kind of working them out can alleviate a fair bit of the pain.

Scot: All right. Our second question here, this is actually a sports question. Boy, this could be a really involved answer, so we'll go ahead and just give this a listen here. Question number two for Dr. Gee, our sports medicine expert on "Who Cares About Men's ÈËÆÞÖгöÊÓƵ."

Man: Hi. I've got a question for your sports medicine doc. I'm just wondering what's your opinion on arm care for baseball players? What should be the limit for how much kids throw, and do you ice, do you heat? What's your opinion on best way to stay healthy?

Scot: All right. So I wanted to tease out there. It sounded like he said arm care, baseball players, and then he said something about kids, so . . .

Troy: Yeah. He's probably got some kid he's trying to get into the Major Leagues.

Scot: It's his retirement policy is what it is.

Troy: Exactly. He's like, "I've got to make money off this kid."

Dr. Gee: What's happened with youth sports over the past 10, 15, 20 years is that when I was kid, we used to just play a season and then you were done and you'd go out and mess around. Now, kids are getting to the point where you play with your high school team, and then you have a competition team, and you have another competition season, and they'll go away to tournaments, and they end up playing throughout the entire year and giving no chance to really rest the arm.

Particularly in pitchers it becomes an issue. In younger pitchers, there are growth plates. So the bones basically expand at these growth plates, and those growth plates have muscular attachments to them. And so when they're throwing really hard, oftentimes that muscle is pulling off of that growth plate and it can cause stress injury to the bone. They can even tear ligaments and cause a lot of problems.

And so there are some great recommendations out there looking at limiting number of innings pitched for pitchers, limiting the number or types of pitches that are thrown. Curveballs tend to be a little more of a dynamic stress on the elbow and on the shoulder, and so they have them hold off of that for a period of time until they hit a certain age, and gradually over time looking at building that up.

So it's something we'll see a fair bit of, and most of the time, you've got a coach that may be good about limiting what his athlete is doing from game to game, but they don't know about all the other games these guys are playing in. And so, as parents, you have to be really careful about how much your kid is pitching, how much your kid is involved in the sport.

Troy: Chris, it sounds like parents looking at regulating pitch counts and the types of pitches thrown, it sounds like that could be pretty involved. Are there any sorts of guidelines, particularly for different age groups and numbers for those groups?

Dr. Gee: Yeah. There are some really good guidelines out there that have been looked at and published and reviewed routinely. You can find those under USA Baseball online and also Major League Baseball. MLB.com has some of those published guidelines, depending on your age and what kind of position that kids are playing.

Scot: Does this arm care just . . . is that mainly for people that are in a pitching position?

Dr. Gee: Yeah, it is. That's the biggest concern is that as they pitch that many hard throws, it just puts stress on their arm. But the other thing you definitely have to think about with these kids is that if they're going from . . . maybe, say, they're playing as pitcher and then they're going to play first base, the rest as first base, they're still going to be throwing quite a bit. And so you've got to really look at how much volume you're putting on this kid's arm.

Troy: I think one of the parts of the listener's question was about icing, and maybe that's a bigger question in general I think probably all of us wonder about. Do you recommend people routinely ice their joints if you're working out a lot? Some people like ice baths, things like that. Is that something you routinely recommend?

Dr. Gee: For sure. Yeah, it's one of those things that what we believe is happening is that as you're working out, you're getting small little tears and little bits of inflammation within the joint and within the muscles. And so placing a little ice on the joint after working out is a good idea. It just decreases the inflammation that's there, allows that to recover.

I'll usually tell people if you're doing a hard workout, ice down for 10, 15 minutes afterwards. And then maybe if you're feeling stiff or tight as you're starting to work out, doing a little heat before a workout just to kind of warm it up should be helpful.

Troy: Okay. So heat before, ice after. You don't recommend if you've got a hot tub necessarily jumping in the hot tub right after your workout?

Dr. Gee: No, not necessarily. There's not a lot of hard science behind it. Most of the research says that icing is most helpful after an acute injury for about a week period, but what most people will do is end up using ice after kind of a workout to try to decrease the inflammation they've developed.

Scot: Is that the secret weapon, if you will, of all of these professional athletes you work with? I see those ice bathtubs that they hop into, which look wonderful.

Troy: Yeah. How did they get in those things, though? I mean, it's . . .

Dr. Gee: Torturous, right?

Troy: I can't imagine.

Scot: You just grit your teeth and do it man, right?

Troy: Seriously.

Dr. Gee: Right. Have you seen Kevin Hart's podcast where he puts athletes into cold tubs and then interviews them as they're sitting there?

Troy: I haven't. That sounds great.

Dr. Gee: That's a new idea for The Scope Radio. You guys should get in the ice tubs.

Troy: There we go. We've got to put every one of our guests . . . just put them in an ice bath and see how they do.

Scot: I have a hard enough time getting guests anyway because of schedules and whatnot. If we're putting them in an ice bath, that's going to making it even harder.

Troy: Yeah, nothing like ice baths. I'm sure that'll go well.

Scot: All right. Our last question here is an email from hello@thescoperadio.com. This is from Val it looks like, so a woman listening to the podcast, which is cool. It's "Who Cares About Men's ÈËÆÞÖгöÊÓƵ," but we . . .

Troy: Well, it could be a man's name too. It could be a man's name.

Scot: Oh, it is? Oh, maybe it is.

Dr. Gee: True.

Troy: Yeah.

Scot: I guess I don't know. Can a torn meniscus heal on its own? If it's not surgically fixed, will it cause a lot of future problems? So, first of all, what's a meniscus? Is that in my nose?

Dr. Gee: Not quite.

Troy: That's mucus, Scot.

Scot: Oh, okay.

Troy: Meniscus is different.

Dr. Gee: "Menucus." So a meniscus is a piece of cartilage that sits in your knee, and it kind of acts as a shock absorber between the bones. As they hit together, instead of hitting the articular cartilage or the lining of the joint against itself, it hits against this meniscus and that absorbs some of the shock.

The meniscus, however, doesn't have great blood supply to it, and so it tends to not heal very well. Some of that depends on where in the cartilage it is. If it's in more of a peripheral zone, where the blood is transmitting a little closer, it can heal, but most oftentimes I'd say they don't heal over time.

The treatment, though, doesn't always have to be surgery because what we want to do is basically allow that meniscus to be in there and act as a shock absorber without having to remove it as long as that meniscus lays down and doesn't get caught in the joint. So every time you flex the knee, it's popping, or it even bends over and kind of gets locked in the knee, then that's something that has to be fixed. Otherwise, oftentimes, I'll recommend we trial injections and some therapy and see how much we can get it to calm down without having to go in surgically on it.

Troy: And it seems like that's a common thing with skiing and that sort of thing. It seems like you hear a lot about meniscus tears here.

Dr. Gee: Oh, for sure. It's a really common injury. They are at a lot of risk. Whenever you're squatting down, bending, twisting, you're just kind of pushing against that meniscus, and so that's why it gets injured so often.

Scot: When my knee pops, is that my meniscus popping always?

Dr. Gee: Not necessarily. It can be the kneecap kind of shifting along as it's moving through the trochlear groove. The meniscus does shift a little bit as you're moving your knee, and so sometimes it is just kind of getting a little catch and it'll just pop. As long as it's not painful and doesn't swell up after it, you can kind of just leave it alone.

Troy: And is this one of those things where physical therapy can make a difference, or are you really looking at injections at that point?

Dr. Gee: Yeah, you can start with some physical therapy with those. The idea with that is, obviously, it's not going to necessarily make that meniscus heal, but it's going to stabilize the musculature around the knee, help it to move more easily and unload the pressure on that meniscus. And as long as it's calming down on its own, you don't have to do anything more. I usually use an injection as sort of getting pain under control so that they can do some exercises and therapy.

Scot: All right. Troy, do you have anything else? I think that was our three questions.

Troy: No. I think it's great information. We covered the back, we covered the arm, we covered the knee, so I think it's a pretty thorough review.

Scot: Yeah. We did all right there. Dr. Gee, are you feeling pretty good about this?

Dr. Gee: Yeah, I feel good about it. It's been good.

Scot: All right. Well, thank you very much for answering our listener questions. We sure do appreciate it, and thank you, Dr. Gee, for caring about men's health.

Dr. Gee: You're welcome. Glad to be on.

Scot: Time for "Odds & Ends" on "Who Cares About Men's ÈËÆÞÖгöÊÓƵ." Got a couple of items here, Troy, that I'd like to throw out there for "Odds & Ends."

The first item is really excited about next week's show. We're going to be talking to a gentleman named Lorne and also psychologist Andrew Smith. Lorne, we're going to find out what his story was in hopes that maybe if you're struggling with alcohol dependence that it will help you.

One thing we learned during the episode, because we've already recorded it -- like many podcasts, we pre-record a lot of our things -- is that it's not necessarily about the drinking. That's just a symptom of a lot of other problems, and that was very eye-opening for me in that episode.

Troy: Yeah, me too. That was the point I think we're going to see really come out in this is that there's a whole lot more to this. And interestingly, that's what the therapy focuses on. It doesn't focus on the alcohol. It focuses on the underlying issues that the alcohol is used to try and cope with. Yeah, really interesting perspective.

I think regardless of where you're coming from, whether you think, "Maybe I do have an alcohol use disorder," or if you're saying, "Hey, I don't even drink alcohol. Why would I care about this episode?" I think it has a lot to it in terms of other things we might do in our lives and maybe other habits we have and how those . . . It's not about that habit. It's about what that is trying to deal with, and then finding that and addressing that. So I think that was the larger point of the . . . that's the big thing I think we're going to hear.

Scot: Item number two, we had Nick Galli on last week. He was our sports . . . he's a mental performance coach. He works with the U.S. Speedskating team, and I've already been able to use some of his advice from his last episode about performing like a pro.

Troy: Nice. You've got people's names right now? I know that was your concern. We had this come up.

Scot: I've had other things that I would like to perform well at, and normally I would get in my own head over. I just try to keep his advice in mind. And a couple pieces of advice that he had in his episode is this thing that you're doing that you're going to gonk yourself at, reframe it. Don't think of it in terms of "This is the most important thing in the world." Think of it as "I'm really lucky to have this opportunity to share this information with somebody" or to share this story.

And then also, just realize you're human, and if you screw up, it's fine. You're in a room with other humans. Just experience that moment together. And it made all the difference in the world. I didn't gonk myself and I didn't have any major problems, but I knew if I did, I'd be able to handle them.

Troy: Nice.

Scot: Check out that episode from last week with Nick Galli and how to perform like a pro.

Troy: And I would sing it, but I . . .

Scot: Na-na-na-na-na-na-na, Thunder! Troy, do the honors of singing, "You've been Thunder Debunked."

Troy: I can't do that, Scot. Come on.

Scot: Thunder Debunked.

Troy: I have to maintain some sense of dignity.

Scot: Thunder Debunked.

Troy: I'm sorry, I can't . . . I think you already did it.

Scot: All right. This segment is called "Nutrition Myths: Thunder Debunked with Thunder Jalili" on "Who Cares About Men's ÈËÆÞÖгöÊÓƵ." Thunder Jalili is our nutrition expert, and we've got him back for another question. We're going to give him some kind of fitness advice or something you might read somewhere, and we're going to find out if it's truth or if it's going to become Thunder Debunked.

Today's question: How many meals should I be eating throughout the day to boost my metabolism? Is there a magic number? I've heard lots of small meals throughout the day boosts your metabolism when you're pursuing weight loss versus only two or three meals.

Thunder: So let me just clarify because people always talk about metabolism and boosting metabolism, but I guess I'm a little ignorant. I'm never quite sure what people mean by that. So do you mean as a way to help you lose weight? Is that the idea?

Scot: I believe that that's what . . . when I hear people say this, that's what I would think as well. So metabolism meaning "Is there something I can do to my body that makes it burn more calories or more calories more efficiently?"

Thunder: Yeah, that would be exercise. So the idea of having six small meals a day, or one meal a day, or three meals a day, or whatever, if you're trying to lose weight, the more important concept there is to eat in a finite period of time, to make sure you have a fasting period in each 24-hour cycle. Sixteen hours is an amount that has been identified that has been a good tool for weight loss. Doesn't have to be 16 hours. Just for caloric maintenance, 12 hours, I think, actually works too. But to have six meals a day, if you have it in that time period, that's fine. It could be three meals a day. It doesn't really matter.

Where I think six meals a day becomes more helpful is not to lose weight but to gain weight. If someone wants to lift weights, wants to build muscle mass, and wants to gain weight, easier to do that if you have more meals because each time you eat, you have protein in that meal, and that protein stimulates muscle protein synthesis. You release insulin, which is an anabolic hormone that leads to synthesis of tissues, including muscle protein synthesis.

So to have increased hits of food and protein and insulin is better to help you gain weight, but I don't really see how that would help you lose weight. So, for losing weight, I go back to the time-restricted feeding and not really care how many meals I'm eating during my allowed eating time.

Scot: So eating six meals throughout the day to boost the metabolism, that has just been Thunder Debunked.

Thunder: Or at least Thunder Modified.

Scot: Thunder Modified. You need to come up with a catchier name, Thunder Modified.

Thunder: Yeah. That's so boring.

Scot: "Just Going to Leave This Here," it could have something to do with health, or it could just be something that's on our mind, or something we want to share. Troy, why don't you start off "Just Going to Leave This Here"?

Troy: Well, Scot, I'm just going to leave this here. I got something that I've got to tell you about it because I don't know if you've ever used this kind of thing. I got a percussion massager. It's one of these things, you hold it and it looks like a speed gun like some police officers hold.

Scot: Oh, yeah.

Troy: Yeah, like holding a radar or speed gun or something.

Scot: Yeah, my chiropractor has one of those. A lot of people will experience those in their chiropractors, and it kind of goes "do-do-do-do-do."

Troy: Exactly. Yeah. And you can buy it online. They're fairly expensive, but you can find some less expensive options. Mine wasn't super expensive by any means, but it's great. I've never used one of these things before. I've had some massagers, but not like this. This really works the deep tissues. I've just got these sore spots I continually deal with. We've talked about IT bands and rolling and all of that. Using it on my IT band, using it on these sore areas on my hip and all of that, and it's great.

So if you've got some sore spots, consider it. I've enjoyed it, and it's working well for me after about a month, and that's what I'm going to leave here.

Scot: Just going to leave this here. Of course, last week, the Vice President of the United States was in Salt Lake City for the vice presidential debate, and I got stuck because of the motorcade. So I'm trying to go through this intersection, and all of a sudden, two motorcycle police cops pull up, and each one of them gets off their bike, and one goes to one side of the intersection, one goes the to other side of the intersection, and then they stop us. So I know immediately, "Oh, the motorcade is going to be coming down the road." Have you ever seen a presidential or vice presidential motorcade?

Troy: I have never had that experience.

Scot: It was crazy. So you've got these cops that did that, that blocked this road. And as soon as they blocked it, two other motorcycle cops, or actually a bunch of them, go zooming by. I don't know how fast they were going on this 35-mile-an-hour road. Presumably doing the same thing, right? I'm sure they're just kind of leapfrogging each other going from intersection to intersection. And then 30 highway patrol motorcycles came rolling down.

I'm going to tell you now that I actually looked this up because I was curious how many vehicles are in a motorcade and how they get all those SUVs and stuff here. So I looked this up and I just want to share it because I'm just nerding out about this. The president could visit three places in a day, which means they might have to have three separate motorcades in three different locations, which blew my mind, first of all. So they transport these vehicles by military planes, like big C-17 military planes.

Troy: Oh, wow. They're not renting from the local Enterprise?

Scot: No, they're not. I don't think the Hertz has exactly what they're looking for.

Troy: Hertz's dollar rental does not carry these SUVs? Okay.

Scot: So, as I'm watching this, you see the police motorcycles, the highway patrol motorcycles, you see police cars, and then you get to the real deal part of the vice presidential motorcade. And they've got all these black SUVs, and they've got one that's for electronic countermeasures, so it jams communications and remote-detonating devices. I saw that one.

Troy: So did your cell phone stop working?

Scot: No, I didn't know at the time. This was in retrospect. I looked it up and I went, "Whoa, that's what that was." And then they've got a truck kind of thing, and that's for hazardous materials mitigation. And it's got sensors to detect nuclear, biological, or chemical attacks, so I saw that.

Troy: So it's actively sensing as it's going past?

Scot: I guess. So I saw that one. And then another SUV comes by and it's a communications vehicle because it has all these antennas on it, and that's exactly what this one was.

Troy: Wow.

Scot: And then you get some of the cars that come by. You don't know which one is carrying the vice president. That's part of the smoke and mirrors, right?

Troy: Are they just a bunch of limos or . . .

Scot: Yeah, there are identical limos and you don't know which one the president is in, and apparently they will switch positions periodically to just keep . . . like a shell game.

Troy: To be clear, this was a motorcade for the vice president?

Scot: Yeah, which I'd imagine is probably very similar.

Troy: It's the same process.

Scot: Yeah, I would imagine. I mean, I don't know for sure. And then towards the back, two ambulances are following this thing. And then you've got a whole . . .

Troy: Were they local ambulances or were they brought in?

Scot: I'm not sure about that.

Troy: Were they Salt Lake Fire or who they were?

Scot: Yeah, I couldn't tell that.

Troy: Couldn't tell? Okay.

Scot: Yeah. And then you've got a whole bunch in the back, a whole bunch more cops and stuff. I mean, this was just an incredible sight. It was just crazy. So I will put a link to the article that I read about it because I thought it was just fascinating, I guess, in a guy geeky sort of way, what it takes to transport this one individual from Point A to Point B.

Troy: That's pretty remarkable.

Scot: It was just crazy. So, yeah, check that out on the show description page. I'll put that up there if you want to check that out.

Troy: The only thing I can compare to that is . . . some of the greatest satisfaction I get from running is running a race, and you've had this too, Scot, running through a city and having the police officers stopping all the traffic and seeing cars lined up like 20-long just waiting for you to run past them. It's not exactly a presidential motorcade, but it is a certain amount of satisfaction. "You guys can wait on me. I may not be going fast, it's Mile 23, but you can wait."

Scot: All right. It's time to say the things that we say at the end of podcasts because we are at the end of our podcast. Troy, go ahead.

Troy: Thanks for listening. Please be sure and subscribe wherever you get your podcasts, whether that's iTunes, Stitcher, Spotify. We're on all the podcasting platforms.

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Scot: And then we also have a listener line. You can leave a message at 601-55SCOPE. That's 601-55SCOPE. Thanks for listening, and thanks for caring about men's health.